Great Oakley 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 high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. We found there was an inclusive and positive culture of continuous learning and improvement shared by all staff. There was a system of governance that aimed to manage risks and keep people safe; however, we found some areas needed strengthening in relation to the review of patients prescribed specific medicines, those at risk of having a missed diagnosis of chronic kidney disease (CKD) at stage 3 and those with a long-term condition. The leadership team advised they had identified these concerns prior to our assessment and were working with a virtual pharmacy team to reduce identified risks. Leaders had a clear business plan and gathered feedback and information about risks, performance and outcomes which they used effectively to make decisions about future developments. This key question has been rated as requires improvement.

This service scored 62 (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. There was a practice mission statement which was ‘Helping people to lead healthier lives’. The practice promoted a positive, compassionate, listening culture that supported trust and understanding between staff and patients using the service. Staff reflected on increasing workload as the practice had seen significant increase in demand for services and had been unable to expand its premises. Nonetheless, they expressed how the practice was a friendly and supportive place to work.

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. Staff told us leaders in the practice was approachable and responded to any concerns raised and modelled the values of the practice. 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.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The practice had a Freedom to Speak up policy that included relevant information about how to contact the Freedom to Speak up Guardian. Staff knew who the Freedom to Speak up Guardian was. Staff told us they were able to raise concerns to each other and leaders at the practice, they told us their concerns were valued and acted upon appropriately.

The practice 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. There were robust, fair and transparent recruitment policies and procedures. All staff had completed equality and diversity training. Adjustments had been made to ensure all staff were valued. Staff felt included and leaders had a structure in place to ensure staff had equal opportunities for career development.

The practice had some systems of accountability and good governance, with clearly defined roles and responsibilities. However, we found areas that required strengthening, particularly in relation to the review of patients prescribed specific medicines, those at risk of having a missed diagnosis of chronic kidney disease (CKD) at stage 3 and those with a long-term condition. The leadership team advised they had identified these concerns prior to our assessment and were working with a virtual pharmacy team to reduce identified risks. This included undertaking audits, urgent reviews of patients, developing and reinforcing policies and procedures and educating staff.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, 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.

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

The provider worked with other practices within their primary care network (PCN) to offer extended access. They also worked with the wider community of practices across the locality to try and improve patient experience. Staff worked with community healthcare services, including through established meetings centred on the care of people who were housebound or had long term conditions.

There was an active and well-established patient participation group (PPG). which was supportive of the practice in driving improvements. The PPG acted as a channel for communication between the local community and the practice. We spoke with a member of the PPG who gave positive feedback about the practice and gave examples of improvements which had been made following patient feedback.

The service focused on continuous learning, innovation and improvement across the organisation and local system. The practice was a teaching and training practice. They supported medical students training to be doctors, student nurses and supported GP registrars, who are qualified doctors training to become GPs. There was evidence of a strong commitment to supporting learning and development in others. Staff were supported with career development opportunities. Learning from significant events and complaints supported continuous improvement across the service. The practice had a quality improvement plan in place to help drive improvements in services.