Oldfield 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 Requires Improvement. At this assessment, the rating has changed to Good.

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 now 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.

Leaders promoted a positive and compassionate culture, demonstrated through regular team meetings, quarterly service closures for development, and open communication channels. Data from their most recent staff feedback survey showed staff reported feeling supported and valued, with 88% stating their opinions were taken seriously and 94% finding it easy to contact managers. Equality and respect were embedded in the vision and values, and staff described the workplace as a nice place to work with opportunities for learning and development

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.

Staff told us leaders were approachable, responded to concerns raised and modelled the values of the service. Leadership visibility was evident through structured meetings, supervision sessions, and involvement in audits and quality improvement projects. Leaders worked with other services in their local primary care network and were engaged in the development of primary care services within the local area.

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

The service had Freedom to Speak Up arrangements, including links with other services in the local primary care network. Staff were aware of how to raise concerns and gave examples of using these arrangements effectively. Leaders actively promoted a culture of openness and empowerment, encouraging staff to speak up and valuing their contributions. Staff told us they were confident their voices would be heard.

When concerns were raised, leaders investigated them sensitively and confidentially, shared lessons learned and took action to prevent recurrence. If something went wrong, people received a timely and sincere apology and were informed about steps taken to avoid similar issues.

Policies on whistleblowing and speaking up were accessible on the service’s TeamNet platform, and posters were displayed in staff areas. Training on whistleblowing procedures was provided, and staff described multiple routes for escalation, including line managers, safeguarding leads, and the Speak Up Guardian. Staff gave examples of raising issues and receiving prompt resolutions, which reinforced confidence in the process.

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.

Policies and procedures to promote equality and diversity were in place. We saw examples of reasonable adjustments to support staff, such as changes to clinic types and working hours following an occupational health assessment.

The service promoted equality of opportunity and inclusion across the workforce. Recruitment processes were revised to ensure fairness, with all roles advertised internally and externally. Pay structures were improved, and career development pathways were introduced for both clinical and administrative staff. Staff wellbeing was prioritised through registration with the Staff Wellbeing Service and protected time for training. Staff feedback indicated high levels of job satisfaction and a sense of being treated equitably.

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

Although the service now had arrangements for monitoring emergency medicines, infection control, and staff training compliance, recruitment documentation was not always complete, and there was a lack of regular review of safety policies and procedures. Risk assessments for certain areas, such as Control of Substances Hazardous to Health (COSHH) for oxygen, were also out of date. Blank prescription stationery was not being monitored in line with national guidance. The service acted immediately to resolve these issues on the day of our onsite visit, however, these new governance processes were yet to be fully embedded.

However, staff could access all required policies and procedures. Leaders held regular service 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 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 collaborated for improvement.

The service partnered with its patient participation group (PPG) to support flu and COVID-19 vaccination programmes and held quarterly PPG meetings. Actions were taken in response to feedback, such as improving digital access and were planning evening sessions to increase engagement.

The service maintained strong links with other organisations, including regular multidisciplinary team meetings with care homes, liaison with the local integrated care board, and participation in local safeguarding forums. Outreach clinics and social prescribing initiatives were in place to address health inequalities and improve access for vulnerable groups.

Clinical staff demonstrated effective partnership working with hospital specialists. Nurses gave examples of collaborating with tissue viability specialists and diabetes consultants to optimise treatment plans and improve outcomes. These arrangements show a commitment to integrated care and shared learning across services.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Multiple quality improvement projects were implemented, resulting in measurable improvements in prescribing safety and care outcomes. Staff were actively encouraged to share ideas for change, and the service embraced digital innovation by trialling AI-assisted note-taking and introducing new templates to streamline documentation and improve efficiency.

The service also operated an active research unit, working in partnership with the National Institute for Health Research (NIHR), universities, and commercial sponsors. Research activity was led by clinical research nurses, a study coordinator, and principal investigators. Posters displayed at the service promoted current phase 3 and 4 studies, and potential participants were invited to take part. One example was the REIMAGINE 2 study, which explores whether a medicine called CagriSema, could help people with type 2 diabetes lower blood sugar and lose weight. This demonstrated the provider’s commitment to advancing clinical knowledge and improving health outcomes.

Feedback collected from participants in the REIMAGINE 2 study which we saw as part of this assessment was positive. People strongly agreed they were well-informed, kept updated, and treated with respect throughout the research process. Participants had reported significant health improvements, including reductions in blood sugar, blood pressure, cholesterol, and weight. Positive experiences centred on clear communication, supportive staff, and regular feedback, reinforcing the provider’s focus on person-centred research and innovation.