Great Ayton Health 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 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 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 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.

The practice’s business development plan stated that their mission was to provide high quality, patient centred care, with excellent accessibility for all age groups and needs. It also stated that the practice aimed to provide a safe and respectful environment for their patients and work collaboratively as a team to ensure patients feel listened to and their concerns addressed to the best of their abilities.

Although not all staff who provided feedback stated that they had been involved in the development of the practice strategy, the majority stated that there was a clear vision and that they had contributed in some way to it.

All staff stated that they liked working for the practice and that there was a positive culture.

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.

All staff stated that they felt supported by their line manager and that support was available from senior managers, who were approachable and visible.

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.

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

The practice had established Freedom to Speak up arrangements with other practices in the primary care network and had an open-door policy if staff wanted to raise concerns.

All staff told us that they were aware of the whistleblowing procedure and most staff stated that they were aware of how to raise concerns.

The service valued diversity in their workforce. They work 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. Equality and Diversity training was mandatory for staff and all staff had completed it.

The service had clear responsibilities, roles, and systems of accountability. They used these to manage and deliver good quality, sustainable care, treatment, and support.

Leaders and managers supported staff, and all the staff we spoke to were clear on their individual roles and responsibilities. Managers met with all staff annually to complete appraisals. The provider had established governance processes that were appropriate for their service although some areas of governance required review, for example, not following their own policy regarding clinical supervision, management of blank prescription security and no risk assessment in place for emergency medicines.

Staff told us that they had enough guidance and could access required policies and procedures. Staff took patient confidentiality and information security seriously.

The service did not always act on the best information about risk, performance, and outcomes however, or share this securely with others when appropriate.

Although the service investigated and learnt from significant events and complaints, some staff told us that this learning was not always shared with them.

Some clinical staff also told us that they did not receive regular competency assessments or supervision.

Some staff highlighted that managers did not hold regular practice meetings with staff during which clinical concerns and emerging risks could be discussed.

Following feedback during our on-site visit, the practice confirmed that they had a plan to develop more structured meetings to include all staff roles and that they would have additional discussion across the practice as to how staff would like to receive learning/feedback from meetings.

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 provider worked with other practices within Hambleton and Richmondshire Primary Care Network to offer extended access, seasonal influenza and covid vaccination programmes.

They also worked with the Heartbeat Alliance (a group of 16 GP practices across Hambleton and Richmondshire) to enhance access to primary care services, offer an extended hours service and provide other services such as menopause clinics, and secondary care bloods. Staff were also being trained to offer spirometry clinics.

There was an active PPG who were positive about how they had engaged with the practice and how their ideas had been listened to and acted on.

To help support children with autism, the practice had worked closely with Harrogate and District Specialist Children’s Services, Child and Adolescent Mental Health Services and community paediatrics team.

The practice also worked closely with a local charity supporting people with dementia and their families across York and North Yorkshire.

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.

The practice had a business development plan in place to help drive improvements in services and recognised that they needed to expand the leadership team and have a succession plan in place.

The practice had recently undertaken a total redesign of their website to make it more informative and patient friendly. Having recognised potential inequalities in information access for the older population, they had also worked with the PPG and set up workshops to raise IT skills and show patients how to use electronic devices to best access the services they need.

Given the recent expansion in staff numbers, the practice was working with NHS Property Services on plans to remodel and refurbish some of their space into smaller, more efficient consulting rooms.

In the longer term, the practice also wanted to explore the possibility of more extensive renovation to enhance patient experience.