Severn Valley Medical 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, we rated the service as Requires Improvement as not all systems and processes for medicines management were operating effectively.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice had a shared vision, strategy and culture. This was based on providing exceptional, professional, patient-centred healthcare that improves the health and wellbeing of patients. The mission statement was displayed in the waiting area and on the practice website. Feedback we received from staff regarding the culture within the practice was very positive. They told us it was a positive and friendly environment to work in, the culture was open, transparent, blame free and non-discriminatory and they enjoyed working there.

The practice had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. Leaders had the skills, knowledge and experience to lead effectively. The practice had a stable and experienced workforce. Staff spoke positively about the leaders and told us 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 fostered a positive culture where staff could speak up and their voice would be heard. Staff were confident their concerns would be acted upon. There were also systems in place to support staff to whistleblow or to speak with a Freedom to Speak Up Guardian if they needed to. The practice had appointed one of the GPs who was not a partner in the practice, to the role of the Freedom to Speak Up Guardian. Alternatively, there was a protocol in place for staff to speak to other parties such as the local integrated care board (ICB).

The practice had systems and processes to promote diversity and equality in the workplace. Staff had received equality and diversity training. They had a zero tolerance to bullying and harassment and were committed to providing an inclusive and supportive environment. A number of staff had longstanding employment with the practice with the average service length equating to over 10 years and 22% of the workforce having 20 plus years of service.

Staff we spoke with were clear about their roles and responsibilities. They had access to policies and procedures and knew who to talk with if they had concerns or questions. Managers met with staff to complete appraisals and performance reviews. Regular meetings were held with staff, during which clinical concerns and emerging risks were discussed. Managers recorded any actions arising from these meetings and ensured they shared these with staff. There were systems in place to ensure staff were kept informed if they were unable to attend meetings.

Our clinical records review however, identified not all systems and processes for medicines management were operating effectively. For example, we identified the process for medication reviews was not consistent with some reviews only coded on the clinical system with no detail or commentary on what had been reviewed. Commentary within patients records in relation to medication reviews provides assurance that clinicians have checked medicines are safe, effective and appropriate for the patient.

We also identified that not all patients prescribed medicines which require monitoring had received necessary tests to provide an assessment of a patient’s health; the effectiveness of their treatment; and to identify any risk factors.

We also found safety alerts were not always actioned in line with guidance. Safety alerts are issued to communicate critical information about the safety of medicines and medical devices to healthcare professionals and are designed to ensure the safe and effective use of these products which may require specific actions to mitigate risks. In addition, our clinical records search identified numerous out-of-date safety alerts on the clinical system. Out-of-date safety alerts could potentially lead to incorrect actions or missed opportunities for patient care.

The practice understood their duty to collaborate and work in partnership, so services worked seamlessly for patients. They shared information and learning with partners and collaborated for improvement. Staff were encouraged and supported to attend local forums which provided networking opportunities with other services within the primary care network.

Leaders told us they strived to ensure primary care network staff engaged with the practice were given direct access to operational staff, so they were well supported and felt part of the ‘extended work family’ at the practice.

The practice had an active patient participation group (PPG) which was supportive of the practice in driving improvements. The PPG acted as a conduit for communication between the local community and the practice.

The practice had a strong focus on continuous learning, innovation and improvement. Leaders encouraged staff to put forward and test out new ways of working. Staff were given opportunities for learning and career development. For example, the practice had mentored the first primary care Advanced Nurse Practitioner in Worcestershire.

Staff participated in quality improvement work and used learning from significant events and complaints to continually improve the service they provided.

Prior to our assessment, the practice had participated in various pilots including piloting ‘Healthtech’ software applications for online patient registrations; and following our assessment the practice was due to commence a pilot for ‘Work Well Coach’ in collaboration with the local ICB and PCN, which offers one-to-one support to individuals experiencing health issues that impact their ability to work.

Leaders were enthusiastic about the patient triage model operated in the practice and told us staff from other local practices had visited to observe how the triage worked. Staff explained they felt their patient triage model was innovative and effective having a clinician sat with the call handler staff to oversee the process.

The practice was a well-established training practice for GP trainees providing medical education for 25 years. Systems were in place to support trainees during their placements.