Westminster Medical Centre

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 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. The rating remains requires improvement following this assessment.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had an understanding of the challenges and the needs of the patient population. There were clear responsibilities for clinical and non-clinical staff. Staff we spoke with told us that the ethos of the service was to provide good, person-centred care. We received feedback from 13 members of staff. They told us there was good teamwork and support from colleagues. Overall, they felt valued and supported by leaders and that they could contribute to decision making about how the service operated and that their opinions would be listened to. However, some staff told us improvements could be made to communication with the management team. We noted that there was no regular formal means of gathering non-clinical staff opinions about their day to day working environment, such as a staff survey or scheduled meetings. Following the assessment the provider sent us a staff survey they had recently carried out and they told us monthly meetings had been planned.

Leaders understood the context in which they delivered care, treatment and support. The leadership team worked with other practices in the PCN and were engaged in the development of primary care services within the local area. Overall, the provider monitored and acted upon data about outcomes for patients and made improvements when required. We have identified that improvements were needed to ensure that action taken to improve patient experience of the service is evaluated to see if it is effective. Staff told us that leaders were visible and were overall approachable. Staff demonstrated an understanding of equality, diversity and human rights, and they prioritised good quality and compassionate care.

Staff were aware of how to raise concerns and about procedures to support this such as the whistle blowing procedure. Staff knew who the Freedom to Speak Up Guardian was however they were not independent of the practice. The provider demonstrated that there was access to independent guardians and that they would ensure staff were aware of this. Staff told us that if they raised a patient safety concern this would be welcomed and acted upon. However, some staff felt that they were not always listened to when they raised issues about their working arrangements.

The provider told us how they worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Reasonable adjustments were made to support staff to carry out their roles. Staff had completed training in equality, diversity, and inclusion and were aware of supporting people with protected characteristics such as age, gender, religion, or disability.

At this assessment we found that overall improvements had been made to meet the requirement notice from the last inspection. However, there continued to be areas where there was insufficient oversight to ensure the service operated safely and effectively.

We found that improvements were needed to the systems in place to monitor on-site medicines and blank prescriptions and review significant events to ensure action taken is effective. The provider took immediate action to address any issues identified in relation to patient safety.

We found that patient feedback in the national GP Patient Survey was lower than local and national averages for questions relating to the service being caring and accessibility. The provider acted on the views of patients; however, they did not have an effective system to record all the action taken and evaluate that the action taken had led to improved patient satisfaction in the areas identified in the national GP Patient Survey.

Although action had been taken to increase the uptake of childhood immunisations and cervical screening, this had only recently been recorded as a plan that could be periodically reviewed.

The provider carried out audits to review the quality of care and treatment provided and how the service was operating.

A clear management structure was in place with designated staff members who acted as leads for clinical and non-clinical areas.

Staff could access all required policies and procedures.

There were arrangements in place for the availability, integrity and confidentiality of data, records, and data management systems and staff took patient confidentiality and information security seriously.

The provider worked in partnership with relevant external stakeholders, commissioners and partner agencies to provide and develop effective services. They worked with the Integrated Care Board to provide enhanced services such as minor surgery and NHS health checks and to review their management of medication.

They provider worked collaboratively with the PCN. Services provided by the PCN included social prescribing, care co-ordinators, physiotherapy services, pharmacy services, women’s health clinics and services to support older people such as weekly visits to review the health of people at local care homes and reviewing older people discharged from hospital.

The practice had a Patient Participation Group (PPG). We met with representatives of the PPG, and they told us the provider was working with them to identify people’s views about the operation of the service. The provider sought feedback from patients and reviewed external sources of feedback such as the national GP Patient Survey and the NHS Friends and Family Test. The provider took action to address shortfalls identified. For example, following people’s feedback changes had been made to the appointment and telephone systems.

Following the last inspection the provider had made improvements to the service overall. Systems for assessing the quality of the service and outcomes for patients were in place. For example, the provider had systems and processes to monitor prescribing of medicines and improve people’s care.

The provider worked collaboratively and in partnership with stakeholders to improve the experience of people who used the service and those within the locality. For example, the provider publicised services offered by community organisations such as health screening and well-being events.

There was a process to identify and investigate significant events and complaints and identify learning. However, a number of non-clinical staff did not think that learning was shared with them or that there was a clear process for doing so unless they were directly involved in the event or complaint.We found that although significant events were reviewed annually to identify patterns and trends, significant events were not revisited to ensure action taken was effective. Following the assessment the provider told us they had introduced monthly meetings for the non-clinical staff where the outcome of complaints and significant event would be discussed.