Gosberton Medical Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

At our last assessment we found that some systems and processes required strengthening to support the safe delivery of care in respect of safety alerts and prescribing of high-risk medicines. At this assessment we found that systems and processes relating to these and other areas, had been reviewed and improved and were well managed.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities.

Leaders worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of innovation and continuous improvement.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their community.

The service had involved staff in revisiting and contributing to the practice’s vision and this was displayed in the meeting room.

The practice told us their vision was “to provide outstanding, compassionate, and accessible healthcare that meets the highest standards of best practice. We are committed to delivering excellent patient experiences, supporting the wellbeing of our staff, and building a sustainable, forward-thinking medical centre that is trusted by our community for generations to come.”

Staff were positive about culture within the practice and described it as open, transparent and supportive with great teamwork.

The practice was aware of their challenges both locally and nationally, for example, the rurality of the location and poor public transport links. To address this and in line with national priorities for reducing health inequalities they aimed to provide as many services in house or locally as possible. For example, they had recently purchased a FENO (Fractional Exhaled Nitric Oxide) machine (used to aid in the diagnosis of asthma) to help address health inequality and offer the service inhouse.

The service had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The service had an experienced and strong leadership team. Staff spoke positively about the leadership, that they were approachable and responded to any concerns raised. We saw the leadership team worked with other practices in the primary care network and were engaged in the development of primary care services within the local area.

The practice was an established part of the local community.

The service fostered a positive culture where staff told us they felt listened to and able to speak up. They felt confident were they to speak up that any concerns would be acted upon.

Staff were aware of who the freedom to speak up guardian was and what whistle blowing was. The practice had established Freedom to Speak up arrangements with another local practice.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

At our last assessment we found that some systems and processes required strengthening to support the safe delivery of care in respect of safety alerts and prescribing of high-risk medicines. We also found that whole staff meetings were not taking place. At this assessment we found that systems and processes relating to these and other areas, had been reviewed and improved and were well managed.

We found the service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes.

Leaders and managers supported staff, and staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews.

There were governance processes appropriate for the service. Staff could access all required policies and procedures. There were a variety of meetings held in the practice for different staff groups, both clinical and non-clinical. There were now also regular all staff meetings held which staff told us they found beneficial.

Leaders told us they had recently been assessed by the local Integrated Care Board (ICB) using their quality and sustainability framework and had been awarded the highest rating.
 

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborated for improvement. The provider worked with other practices within their primary care network (PCN) to offer enhanced access appointments.

The practice had forged strong links within the community in order to ensure a holistic approach to patient care and in order to offer additional services locally for patients.

The practice had an active Patient Participation Group and worked cohesively with them, acting on feedback from them to improve services. The PPG were consulted on proposed changes and involved in their implementation. For example, the PPG had been involved in the recent implementation of the triage system and assisted with patient education to support a smooth transition to the new system. The practice acted on feedback from the PPG to improve services.

Despite there being a care home service provided by the local PCN, the practice worked closely with the care homes where some of their patients lived to ensure a joined-up service. Feedback from representatives of care homes we spoke to was generally positive about practice staff, their responsiveness to requests and their knowledge of their patients.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe and effective practice.

Since our last assessment the practice had implemented a number of new systems to improve efficiency and effectiveness. These included a system designed to optimise, standardise and automate clinical and administrative processes in order to improve the quality and efficiency of care.

The service was a well-established training practice for GP trainees. Systems were in place to support trainees and students during their placements. The service used learning from events, complaints and feedback to continually improve the service they provided.

One of the GP partners was the cancer lead for the local PCN and there was a focus within the practice on cancer awareness, prevention and early diagnosis with a number of initiatives having been implemented.

Staff participated in quality improvement work, including their own audits.

.Staff roles were regularly reviewed with new roles being established in order to support safety and improvement, such as the appointment of a quality improvement lead and an overall lead for significant events.

The practice was conscious of its sustainability and environmental footprint. To support this the practice had signed up to the RCGP green practice tool kit initiative. The aim of the toolkit was to help general practice improve sustainability; reduce expenses and reduce carbon footprint. In line with this the practice had taken a number of actions to improve energy efficiency, reduce waste and encouraging sustainable staff practices.