The Heron 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 remains the same.

This service scored 71 (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 clear vision of providing “Kind, Courteous, Consistent Care”, supported by an established mission and set of values focused on kindness, courtesy, consistency, respect, integrity, teamwork and excellence. Leaders told us these values were developed collaboratively with the whole team as part of wider work to strengthen staff morale and culture. The vision emphasised delivering accessible, respectful and consistent care while supporting staff and continuously improving services.

The service had inclusive leaders who understood the context in which care was delivered and demonstrated commitment to the service's values. Staff told us partners were visible within the organisation and attended regular clinical and non-clinical meetings, enabling concerns to be escalated and addressed promptly. Survey feedback showed staff felt partners cared about employees, valued their contributions and listened to staff views and ideas.

Leaders demonstrated an awareness of operational challenges affecting both staff and patients. For example, they had responded to workforce pressures, sickness absence and staff turnover by redesigning workforce structures, cross-training staff and introducing new ways of working to improve resilience. Staff reported feeling supported by leaders and described a culture where they could contribute to service development.

The service fostered a positive culture where staff felt able to speak up and be heard. A named Freedom to Speak Up Guardian was in place and staff had access to policies describing how concerns could be raised internally and externally. Leaders promoted open communication through regular meetings and staff engagement activities.

Staff survey results demonstrated that staff felt comfortable raising issues and concerns. Staff told us they felt feedback was listened to and resulted in visible changes within the service. Staff also reported that managers and supervisors could escalate concerns to partners and that issues were addressed in a timely manner.

The service valued diversity within its workforce and worked towards maintaining an inclusive and fair culture. Staff survey findings showed staff viewed the practice as inclusive across age, disability, ethnicity, religion and gender. Leaders monitored workforce culture through regular staff surveys and used feedback to identify opportunities for improvement.

Policies covering equality, diversity, bullying and harassment were in place, and the service demonstrated a commitment to supporting staff with different needs and circumstances. Reasonable adjustments were considered for staff and support was provided to help individuals remain in work.

The service had also implemented initiatives intended to improve workforce wellbeing and inclusion. Staff described a positive cross-team culture between clinical and non-clinical colleagues.

The service had clear governance arrangements, defined leadership responsibilities and systems of accountability. Named leads were in place for key areas including safeguarding, infection prevention and control, medicines management, complaints and information governance. Governance oversight was maintained through a programme of regular clinical, operational and practice meetings where quality, safety, performance and workforce matters were discussed. However, improvements needed to be made in medicines optimisation at the practice.

Staff understood their roles and responsibilities and were supported through supervision, appraisal and ongoing development processes. The service maintained systems to monitor risks, incidents, complaints and performance, with learning shared through established governance structures. Meeting minutes, audit activity and action plans were used to monitor progress and support improvement.

Leaders had taken steps to improve the long-term sustainability of the service. The service also maintained information governance processes and secure methods of sharing information with relevant organisations when required.

Staff could access all required policies and procedures.

The service understood the importance of partnership working and collaborated with a range of organisations to improve outcomes for patients. Staff worked closely with local authority teams, community organisations, voluntary sector partners and services supporting asylum seekers to help people access healthcare and wider support services. These partnerships enabled the service to identify unmet needs within the local population and coordinate support more effectively.

The service also worked collaboratively within the wider healthcare system. Leaders shared learning relating to digital innovation and service improvement through the primary care network and integrated care system.

Patients and community representatives were involved in shaping services through an active Patient Participation Group. The service had undertaken local engagement activities, including a community health fair, to strengthen links with local people and encourage participation in service development.

The service demonstrated a commitment to continuous learning and improvement. Leaders regularly reviewed patient and workforce feedback, performance data and audit findings to identify opportunities for development. Improvements were monitored through established governance arrangements, including meetings, audits and quality improvement activity.

The service introduced a range of innovative approaches to improve access, administrative efficiency and patient engagement. Leaders evaluated the impact of these initiatives and used data and learning to inform further service development.

Staff were encouraged to contribute ideas for improvement and innovation, and examples showed how feedback influenced workforce arrangements, training opportunities and administrative processes.

The service also contributed to wider system learning by sharing successful initiatives through local networks and supporting developments in community outreach, environmental sustainability and referral pathways. The service contributed to research and improvement activity and promoted creative approaches to improving people's experience, outcomes and quality of life.

A quality improvement programme provided a structured approach to service development, including a focus on improving access and appointment systems. Staff across the organisation were encouraged to test and implement new ways of working, with examples demonstrating how frontline teams contributed to service improvements.