Tredegar 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 leaders and staff 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.

Staff we spoke with shared the provider’s desire to deliver high quality patient-centred care and foster a strong partnership with patients to achieve the best possible health outcomes.

Leaders and staff understood their patient population, their cultural needs and challenges. Staff told us they felt well supported by their leaders. All staff had contributed to the development of the service’s vision and strategy, which was kept under review. The service had developed values that would help them achieve this vision. The values included delivering a professional, safe and equitable service to patients. Staff demonstrated a well-developed understanding of equality and diversity, and how to prioritise safe, high-quality care.

The service was led by inclusive, skilled leaders who followed the organisational values. They actively collaborated across the primary care network to improve local services. Leaders we spoke with understood the importance of protecting individuals from discrimination and promoting equality in the workplace. Leaders told us they worked to foster a culture of staff wellbeing.

Staff told us they were happy working at the service and that leaders were approachable and responded to any concerns raised. Staff used words such as “supportive”, and “open” when they described leaders who they worked with.

We saw the leadership team (GPs and clinical leads) worked with other practices in the 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. Staff said there were no barriers to speaking up and their views were listened to and acted upon. This aligned with the management approach of being actively engaged with staff to seek their views.

The service had a freedom to speak up (FTSU) policy with the contact details of the practice’s FTSU guardian. Although there was guidance for staff to approach external organisations, the policy did not have contact details for the local or external FTSU guardian, should staff not be confident to raise concerns internally. Staff we spoke with were aware of how to raise concerns. Processes ensured that when things went wrong, people received an apology and were told about action that would be taken to prevent the situation happening again.

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. Policies and procedures to promote diversity and equality were in place.

We saw adjustments had been made to ensure all staff were valued. Leaders provided training and resources to ensure staff were aware of their rights, including those related to equality, dignity, and respect in the workplace.

The leaders held regular meetings where staff could raise concerns. Staff reported being supported if they were struggling at work. Staff members told us they felt encouraged to contribute their ideas. Leaders told us they valued and supported all team members.

Staff did not always follow the systems in place to ensure good governance. For example, systems for responding to medicines safety alerts required improvement. and managers had not met with all staff annually, to complete appraisals and performance reviews.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Staff we spoke with knew who the relevant lead person was for areas such as safeguarding, infection control and significant events monitoring. Staff took patient confidentiality and information security seriously. Leaders were prioritising succession planning as a partner planned to retire in the next few years, to ensure the continued delivery of high-quality care.

Staff could access all required policies and procedures. Managers held regular practice meetings and daily clinical huddles 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 patient confidentiality and information security seriously.

Staff 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.

Leaders told us they collaborated with stakeholders and had integrated care meetings with district nurses, care agencies, mental health services, care coordinators and palliative care services. They had multidisciplinary team meetings monthly to discuss and improve outcomes for people with complex needs and a bi-monthly meeting with the health visitors to discuss child safeguarding.

The service was actively involved in their local primary network, where they worked with other services to improve the local health inequalities. Staff worked with other practices within their primary care network to offer extended access, referral to rapid response, domiciliary phlebotomy for housebound patients and flu, shingles and covid vaccination programmes. Staff had made adjustments to improve coordination of their service with community healthcare services.

Leaders focused on continuous learning and improvement across the organisation and local system. They actively contributed to safe, effective practice research and training. Staff told us they felt proud to be a training service. The service had 1 qualified GP trainer and 1 GP registrar. Leaders told us they supported trainee service nurses through the Tower Hamlets GP Federation’s Open Doors programme which provided education and support for nurses, and health care assistants working for GP surgeries. Leaders took staff development seriously. For example, leaders had supported a member of staff who had started working at the service as a receptionist to become a registered nurse and they were now a member of the practice nurse team. The service had a quality improvement plan in place to help drive improvements in services. They also had an action plan which reviewed data from the national GP patient survey, this focussed on staff and the appointment system. All staff were encouraged to put forward and test out new ways of working.