Pathfields Medical Group

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 assessed all quality statements in the well led key question. Our rating for this key question remains good. Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were positive about the direction and culture the senior leadership team had promoted. At the time of this assessment, the service was developing their shared vision and strategy in collaboration with the staff team ensuring they focused on understanding the challenges and needs of people and their communities. The service had a quality improvement plan to continue to progress their commitment to people. Staff told us there was an open-door policy where they could access and speak openly to leaders. Staff were encouraged to keep their knowledge and skills up-to-date in line with continued professional development to support the service. Regular meetings and newsletters kept staff up-to-date with any changes or progress the service had made.

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. Leaders included staff in their planning for the future. Staff told us they were well supported by leaders who were visible and approachable. They told us leaders supported them in professional and personal matters. 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.

There were policies and processes to support speaking up and these were accessible to all staff online. These included the name and contact details of the freedom to speak up guardian (FTSUG). The service fostered a positive culture where people felt they could speak up and their voice would be heard. Not all staff knew who the FTSUG was, but they told us where they would find the information. Staff felt confident to raise any concerns with their managers and leaders.

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 gave examples of reasonable adjustments the service had made to support them both at work and in personal circumstances. Policies and procedures to promote diversity and equality were available to staff. Staff were able to explain their understanding of equality, diversity and inclusion and had completed training in this area.

The service had clear responsibilities, roles, systems of accountability and good governance. Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on information about risk, performance and outcomes, and shared this securely with others when appropriate. Effective processes were in place for managing risks, issues, and performance. There was evidence of systems and processes for learning, continuous improvement, and innovation. Regular meetings were held to discuss clinical concerns, review incidents, and share learning. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Managers met with staff regularly to complete supervisions, appraisals and performance reviews. Staff took patient confidentiality and information security seriously. Staff had access to all policies and procedures.

Staff and leaders had established working relationships with community stakeholders sharing their specialist knowledge, skills and experiences. For example, the service worked closely with a local drugs and alcohol charity to provide support for people with complex needs which provided an effective and seamless service for them. Staff had made adjustments to improve coordination of their service with community healthcare services. There were established systems with partner organisations to support people. For example, there was an appointment request form for partner organisations to complete which used a simple traffic light system to easily identify the urgency of the request. Feedback from partners was positive about the service listening to the concerns being raised. One partner organisation told us the service “provides an excellent service to our service users, having a dedicated phone line and email is excellent, and works well.” Another said, “the paramedic team that contacts us when we send email[s] are brilliant very friendly and professional”. The service worked closely with its patient participation group to gain an insight of their experiences of the service.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff told us they had been encouraged to develop their skillset to enable them to take on new roles, responsibilities and further their careers. All staff were encouraged to put forward and test out new ways of working. The service 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 service had a quality improvement plan to help drive improvements. For example, a functional illness clinic had been developed and ran twice a week to see people presenting with physical symptoms where there was no simple medical explanation (e.g. chronic pain, cyclical vomiting). The clinic was supported by 4 GPs and a physiotherapist to work with these often hard to reach people. The structure of this clinic meant people could see the same clinician to promote continuity of care which encouraged people to engage with their care and treatment plan. Clinicians also liaised with other organisations such as local hospitals or learning disability services to support a multi-disciplinary approach to gain the best outcomes for people. The service was aware of its patient population and looked at how to better support specific patient groups. For example, the service was developing a way of monitoring people that identified as transgender to ensure they were included, where necessary, in gender-specific health screening. An information pack was also being created to share with these patients to support them with their health needs.