Hull Family Practice

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 has remained the same.

The service was in breach of legal regulation in relation to safe care and treatment and fit and proper persons employed.

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 did not have a clear vision, strategy and culture which had been developed and shared with staff based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They understood the challenges and the needs of people and their communities.

Although most staff thought the practice had a vision for the future some staff told us they had not contributed to the development of a vision and strategy.

The practice had started to merge with other practices in 2015 with the most recent of 7 mergers in 2024. The provider said there had been a lot of challenges in taking these practices over but had worked with staff and patients to improve these services and discussed the impending mergers with their staff.

The last practice to be taken over by the provider was separately registered as a location under this providers registration at the time of our visit and so did not form part of this assessment. An application for the relevant changes to merge into one location had been submitted. A new partner had recently joined the practice and applications to register them had not been submitted at the time of this assessment.

Due to the size of the overall practice, the provider had developed into a single Primary Care Network to deliver integrated services to their population. They had clear plans for improvement and had completed the GP improvement programme (GPIP) in 2024 which included improving access for patients.

They supported staff development and encouraged staff progression within the organisation.

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.

Most staff told us leaders in the practice were approachable and responded to concerns raised. Some staff felt managers were not visible and did not visit branch sites regularly, however, they said managers were always available by telephone. Some staff did not always feel listened to, and did not have the opportunity to attend regular practice meetings. The managers had recognised that, as the practice had grown, they had not always been able to offer the support they wanted. The practice had also undertaken a staff survey in December 2023 and had developed an action plan for improvement following this. Actions implemented had included expanding the management team and introducing additional lead roles for separate teams to support staff on a day-to-day basis. Daily individual team huddles had been introduced to share information/updates and to promote team working

They had also reviewed, improved and implemented new systems for annual appraisals and clinical supervision.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had established Freedom to Speak up arrangements. Staff were aware of how to raise concerns and had received training in these processes. The practice had undertaken a staff survey in December 2023 and had developed an action plan for improvement following this

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff had access to an equality, diversity, and inclusion policy and had completed relevant training.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They mostly acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders and managers supported staff, and staff we spoke with were clear on their individual roles and responsibilities. New systems had been implemented to complete appraisals and performance reviews although not all staff had received these there was a schedule in place to complete this work. The provider had established governance processes that were appropriate for their service.

Staff could access all required policies and procedures although some policies and procedures were not complete. Some policies were not dated and had not been reviewed regularly. Policies and procedures had not always been followed for example, for recruitment and medicines management.

Managers held regular meetings with staff, during which they discussed clinical concerns and emerging risks. Information in relation to safety incidents and safe storage of vaccines had been presented at meetings for staff. Representatives from each staff group, on a rotational basis, attended the meetings and fed back to their teams. Full practice meetings were held occasionally but some staff said they did not have the opportunity to attend meetings. Records of meetings were varied in quality and did not always clearly record actions arising from these meetings. Staff took patient confidentiality and information security seriously.

There was a business continuity plan.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Due to the size of the practice the provider had formed their own primary care network (PCN) to offer extended access, and flu and covid vaccination programmes.The practice was also part of Hullcare Federation, a group of 3 PCNs in Hull, involved in improving winter access and more recently implementing a pilot for health checks.

Staff worked with community healthcare services, and this included regular meetings centred on the care of those with complex needs.

The practice had a small patient participation group (PPG) and held meetings twice a year and they had been involved in the development of the new triage system to improve access. The practice was looking to relaunch this group to try to encourage a more inclusive membership.

The practice encouraged patients to give feedback about the service by sending Friends and Family test (FFT) questions via a text messaging service immediately after an appointment. The FFT results showed mostly positive feedback for example, practice data showed a total of 417 responses were received in December 2024, with 254 patients (61%) rating the service they received as excellent and 104 (25%) rating the practice very good. They had taken action to improve in response to feedback.

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 taken part in the National General Practice Improvement Plan (GPIP) in 2024 and this had focused on improving the appointment system resulting in positive improvement in patient satisfaction and staff experience. All staff were encouraged to put forward and test out new ways of working. For example, members of the nursing team had put forward ideas for improvement, they had been encouraged to develop a business case for this and the improvements suggested had been implemented.

The provider encouraged and supported staff to develop and encouraged career progression through the organisation. For example, one of the nurses had started as a phlebotomist, became a health care assistant (HCA) and was then supported to undertake nurse training. Pharmacists had completed additional training in long term conditions to enable them to support this group of patients.

The practice was a training practice providing training for year 3 and 4 students from Hull and York Medical School and year 5 students from Kings College London. They also provided GP registrar training and placements for foundation year 2 doctors. The practice was involved in a clinical research study looking at patients with respiratory disease and was working in collaboration with other services within the city.