Peak & Dales Medical Partnership Also known as Bakewell 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 requires improvement. At this assessment, the rating has changed to Good.

This service scored 75 (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, inclusion and engagement. Staff were mostly aware of this vision, however most staff told us they had not been involved in developing the vision.

The practice understood the challenges and needs of people and their communities. They were very aware they had an older practice population and were working with partner agencies to address future challenges. For example, a support group for carers.

The service had 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 and experience to lead effectively. We received positive feedback from leaders and staff regarding the addition of a new partner to the practice.

Most staff told us that leaders were approachable and that their views were listened to and acted upon. Staff gave us many examples of this. For example, the purchasing of new kitchen appliances, the recruitment of more reception staff and support to access the Bike2Work scheme. 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 service mostly had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There was a system to record and investigate complaints. When things went wrong, staff apologised and gave people support. We looked at 7 complaints and found they had all been acknowledged by the provider. The provider told us they had responded to all of the complaints. However, they could not evidence that a formal written response had been provided to 4 out of the 7 complaints or, that these complainants had been signposted to the Parliamentary and Health Service Ombudsman (PHSO).

The provider had processes for staff to report incidents, near misses and safety events. Managers encouraged staff to raise concerns when things went wrong. Significant events and complaints were standard agenda items at practice meetings. Staff were able to give examples of learning from significant events and felt there was an open culture, and that safety was a priority. Learning from incidents and complaints resulted in changes that improved care for others. There were systems in place to summarise and analyse trends in significant events and complaints to monitor that changes had been effective.

The service strongly valued diversity in their workforce. They had an inclusive and fair culture which had significantly improved equality and equity for people who worked for them. Policies and procedures to promote diversity and equality were in place. We saw senior leaders had addressed concerns related to racial discrimination. Adjustments had been made to ensure all staff were valued.

Four members of staff with neurodiverse needs had been supported to develop in their roles, or new roles, when their neurodiversity had affected their ability to carry out their existing role. These staff had been offered individualised support, acceptance and understanding.

One member of staff described how they had struggled in their original role. They told us how leaders had identified and understood their unique strengths and challenges and changed their role to successfully embrace their strengths. This made them feel extremely valued by the service. Another member of staff had been supported to progress their carer throughout the practice and another member of staff had been supported to carry out additional training to improve their performance within their role.

We found that the service had provided personalised equipment to support people within the work environment. For example, standing desks and support with the Bike2Work scheme which had helped to improve the physical and mental well-being of a member of staff.

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, and shared this with others when appropriate.

Leaders and managers supported staff, and most staff we spoke with were clear on their individual roles and responsibilities. The provider had established governance processes that were appropriate for their service although complaints records needed to be more organised. Staff could access all of the required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

The service could evidence that they had succession planning in place to promote the development of the service going forwards. Some staff raised concerns regarding how information was communicated throughout the practice. Leaders were aware of these concerns and described the actions they had taken to address this. For example, sharing information in various ways through email, a closed social chat group, team meetings and a newsletter to staff. Several members of staff told us that communication had started to improve of late.

The service maintained an action plan that focused on priority areas where the service needed to take action. For example, promotion of continuity of care, patient communication and the use of digital patient facing services.

The service mostly understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborate for improvement. For example, the Primary Care Network.

Feedback from 2 care homes where they provided care and treatment was very positive about the responsiveness of the practice when there were issues. Feedback from another care home was less positive. Feedback from a representative of the Patient Participation Group (PPG) was mixed. They told us that a recent PPG meeting had been held but prior to this they had not met since June 2024. They told us they felt the PPG was a tick box exercise and their opinions were not always listened to or acted on. For example, the need to educate people that failed to attend for their appointments.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcomes and quality of life for people. For example, the diabetic specialist nurse and champions for carers and people with autism. They used complaints and significant events to drive improvements throughout the practice. For example, the practice had carried out a significant event analysis when they identified that phlebotomy needles should be disposed of in orange lidded sharps bins. Yellow lidded sharps bins were only available in Derbyshire. After contacting a supplier, they introduced orange lidded bins into the practice and shared their learning with other practices to raise their awareness and promote safer practice across the Integrated Care Board (ICB).

Clinical audits were in place to drive improvements in people’s care. The provider sent us a sample of clinical audits carried out in the practice. For example, the monitoring of people prescribed combined oral contraceptives. However, second cycles to review the effectiveness of changes made had not always been completed. They had also carried out clinical audits to monitor the prescribing and monitoring of people taking high risk medicines. The dispensary participated in The Dispensary Services Quality Scheme (DSQS) and had carried out audits that focused on ensuring people prescribed steroids were issued a steroid card. Changes had been made and a second audit demonstrated that the changes had mostly been effective.

The service had analysed the latest results from the National GP Patient Survey. To understand the reasons for the low responses in one area, they had carried out an inhouse survey and, an action plan was put in place to address the concerns found. They also analysed data from the Friends and Family test to monitor patient satisfaction with access to appointments.