The Park Surgery

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.

The service was in breach of legal regulation in relation the of management and oversight of fire safety, infection prevention and control oversight of the temperature records and storage of vaccines.

This service scored 68 (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 communities.

Most staff felt the practice had a vision for the future and that they had been involved in the development of this through a staff survey. The vision and strategy was displayed in the practice. The practice worked with partner agencies to address future challenges and had worked well with community services to meet the needs of their patients and improve care.

The practice had undergone significant changes in the last 2-3 years, and they had had a significant turnover of staff which had impacted on staff who remained. The staff told us that due to recruitment to vacant posts now being almost complete the practice and working conditions were improving.

The practice was service user focused, and significant changes had been made to improve access for patients. Care and treatment was regularly reviewed and improvements were implemented where required to ensure good outcomes for patients and this was evidenced in our clinical search findings.

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, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Some staff did not feel all leaders in the practice were approachable and they didn’t always feel listened to, however, they told us they were well supported by their immediate team leaders and thought the practice had improved as staffing had stabilised. Other staff told us they were well supported by all leaders and felt involved. The provider had recognised that staff communication could be improved, and further support was required. They had recently employed an operations manager whose role included improving engagement and communication with staff.

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.

People did not always feel they could speak up and that their voice would be heard.

The practice had established Freedom to Speak up. Staff were aware of how to raise concerns. Some staff told us they did not always feel listened to.

There was a no blame culture and staff were encouraged to report incidents. This was evidenced in the incident records we reviewed, and action taken by the practice in response to incidents to ensure improvement.

The provider had recognised that improvements in communication were required and had implemented a staff survey about their experience at work which staff could respond to anonymously. An action plan to improve had been developed.
 

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. Adjustments had been made to ensure all staff were valued, for example, adjustments to working hours requests were considered for staff.

The service had clear responsibilities, roles, systems of accountability but they had not always mitigated risk through good governance. They always acted on the best information about performance and outcomes but not always about risk.

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

The provider had established governance processes that were appropriate for their service. However, not all processes relating to fire safety, infection prevention and control (IPC) and safe storage of vaccines had been fully implemented or maintained. There was a lack of management oversight where these tasks had been delegated. Fire safety risk assessment did not identify all risks, and not all risks had been mitigated. Regular fire checks had not been completed consistently. IPC audits had not identified all risks and where risks had been identified there was a lack of improvement action. There was a lack of records where there had been a temperature excursion in the vaccine fridges to show risks had been identified and mitigated and a lack of management oversight of the temperature records and monthly audits.

Staff could access all required policies and procedures. Managers held regular practice meetings with clinical staff and team leaders, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings. Other staff groups did not feel they had regular meetings and felt there was insufficient time for these to be held. Staff took patient confidentiality and information security seriously.

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 collaborate for improvement.

The practice had recently re-established their patient participation group (PPG). They had promoted the PPG in a joint local paper article to help patients understand what a PPG was and how joining could help both patients and the practice. The PPG representative told us the practice staff attended the meetings and were open and transparent and they felt listened to. They told us the practice had improved particularly with access and in the dispensary.

The provider was the lead for the area Integrated Neighbourhood Team.The provider worked with other practices within their primary care network and local community teams to improve services for patients. They had delivered multiple collaborative community projects over the last two years such as improving screening uptake and blood pressure monitoring.

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, effective practice and research.

The practice had a quality improvement plan in place to help drive improvements in services. This had focused on the appointment system over the last 2-3 years, and significant changes had been made to a new a total digital triage model. Through regular audits they had tracked their progress in improvement and shown improved capacity and reduced call wait times. They had also been able to improve outcomes for patients through more participation in research projects. They told us they had improved the management of patients with long term conditions such as blood pressure and reduced Opiod prescribing. They told us they had shared their experience of total digital triage widely locally and nationally. For example, with other local practices to enable them to develop similar systems in their own surgery and they had presented their system at a national conference for the past two years. They had also worked with NHS England to produce an article about the system to help others in general practice.

The practice was a training practice for GP registrars for 6- or 12-month placements. They also helped train Foundation Year 2 students and had a teaching partnership with the Hull York Medical School (HYMS) and accepted Year 3, 4 and 5 medical students in the practice. Two of the doctors were also accredited HYMS tutors.