Ixworth Surgery

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• 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.

This key question has been rated as good.

Leaders and staff had a shared vision and culture based on listening, learning and openness. Leaders were visible, knowledgeable and inclusive and supported staff to 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 and the service had effective governance systems. Leaders 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 75 (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 shared mission, strategy and culture. This was based on teamwork, equity, equality and human rights, diversity and inclusion, engagement, and understanding the needs of people and their communities.

The service had a mission to provide excellent 21st century medical care, whilst retaining the traditional style and personal approach of country doctoring. We observed this during our on-site assessment. For example, people were greeted in the waiting room by the clinician they were seeing. We received positive feedback from people about this.

Service leaders had a development plan for 2023 to 2026. The service was aware of the projected increase in the local population and was working with partner agencies to address future challenges. Staff told us that there was a supportive, people and team focused culture, and leaders were open to change.

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 had specific roles and responsibilities, and staff we spoke with knew who the designated leaders were. Leaders had an open-door policy and had regular engagement with staff through team meetings. Staff could submit staff suggestions anonymously, however all staff we spoke with advised they were able raise any suggestions or concerns in person. Examples of changes in response to staff feedback included moving administration staff to a more central location and improved heating in some of the clinical rooms. A monthly newsletter was provided to staff. Staff told us leaders were approachable and responded to any concerns or suggestions raised.

Leaders were aware of the challenges of delivering safe, sustainable high-quality care. They had made changes to develop the management team for improved clinical and managerial leadership, and flexibility in staffing resource, to meet the needs of people who used the service. Arrangements were also in place to ensure effective and supportive working relationships with the Nurse Practitioner team. Six monthly meetings were held with this team and GP partners to discuss clinical issues, upcoming changes, raise queries and concerns, make suggestions, and adapt clinical rotas if needed.

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

The service had established Freedom to Speak up arrangements. Processes were in place for staff to speak up, which included Freedom to Speak up arrangements with internal and external Freedom to Speak Up Guardians. All staff had completed Freedom to Speak Up training.

Staff told us leaders were visible and approachable. They were aware of how to raise concerns and were listened to. Staff provided examples of occasions when concerns or suggestions had been raised, listened to, and acted upon, which had resulted in positive changes.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service had processes in place to support workforce equality, diversity and inclusion, with an emphasis on the safety and well-being of staff. All staff had completed training in equality, diversity and human rights. Individual staff risk assessments were in place to support staff safety.

Adjustments had been made to ensure all staff were treated equally and valued. Some staff gave examples of reasonable adjustments that were in place, which included flexible working and more frequent one to one support meetings.

Leaders held social events to support team building which included a summer pizza making party and a Christmas party.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. The service had arrangements to ensure business continuity in a range of emergency circumstances.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers and team leaders held regular practice, clinical and governance meetings with staff, during which they shared updates and discussed clinical issues and emerging risks. Actions arising from these meetings were documented and available to staff. Staff took people’s confidentiality and information security seriously.

We saw examples of environmentally sustainable practices in place, for example, an electric vehicle charging station had been installed for the medicine delivery van and solar panels and batteries had been installed on the roof to support essential services in the event of a power cut.

The service understood and carried out their duty to collaborate and work in partnership, and services work seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider was a member of Blackbourne Primary Care Network (PCN). (PCNs are groups of GP practices who work together to improve primary care services). The leadership team met regularly with PCN members and were engaged in the development of primary care services in the local area. For example, they provided an enhanced leg ulcer service as part of the PCN, with delivery undertaken by individual practices. We received positive feedback regarding the positive, collaborative and responsive approach of the management team and PCN GP lead.

The service worked in collaboration with the pharmacy part of the business to refer people under the Pharmacy First scheme so that people could be seen and treated immediately for certain conditions by a pharmacist. Leaders also worked in partnership with The Patients Association - Ixworth Surgery to share updates with members to share more widely to people who lived locally. Partners agencies we received feedback gave positive feedback regarding the professionalism and responsiveness of staff.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. There was a positive learning culture in the service which staff and leaders encouraged and participated in.

The service is an approved training practice and had 2 GP Registrars (qualified doctors training to become GPs). They had 1 GP Trainer, and another GP was currently completing this course. Leaders also supported the development of their staff. For example, a Dispensary Apprentice was supported to complete a Diploma in Primary Care and Health Management and progressed to the Practice Manager role. Staff gave examples of conferences they had been supported to attend which were relevant to their job role.

The service completed clinical audits to ensure the quality and safety of people’s care and treatment was effectively monitored. The service had previously participated and supported health research but was not involved in any research at the time of this assessment.