Midlands Medical Partnership

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 changed to outstanding.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were 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. There were examples of the practice spearheading outreach work, working in partnership with different local communities and responding to their needs by implementing audits and quality improvement plans which resulted in better reach of patients and or outcomes. Leaders demonstrated excellence in identifying and responding to local needs and harnessing national and local opportunities to the benefit of their patients and the community.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people andtheir communities. Staff were well-informed, supported and collaborated in achieving the vision, values, and strategic objectives.

The service maintained a vision and values statement focused on; ‘Taking care.’ Their vision was to be a high-performing, forward-thinking, and patient-focused super-practice that delivered equitable access and excellent care. Staff we spoke with were aware of this statement which was posted at each site.

The service maintained a business plan which was regularly reviewed, revised and updated. We found there was strong clear leadership. We saw colleagues listened to their staff at all levels, seeking to learn what was working, what they were proud of, as well as any concerns or improvement suggestions. There was diversity of thought and expertise throughout the teams.
Staff we spoke with were aware of freedom to speak up, had been in receipt of training and policies were available which included internal and external contact details and notices were posted at each site.

Staff had access to clinical supervision, learning and development events as well as educational support and all staff had access to online learning systems. The service provided regular reflective practice sessions, enabled flexible working where able, particularly for staff managing heavy caseloads or personal challenges as discussed via their annual or probationary appraisals.

The service was a training practice.

The service analysed health inequalities data to identify gaps in care for vulnerable groups such as people who experienced homelessness, substance misuse, multiple long-term conditions.

They were a ‘Safe Surgery’ as in a GP practice committed to addressing the barriers many migrants face when accessing healthcare are a safe surgery. The practice was also an armed forces veteran friendly accredited GP service.

The service led on multi-agency meetings with social care, mental health teams, and community trusts to coordinate care for complex patients, reducing unplanned admissions and AE use. They had reviewed and considered digital inclusion initiatives, for example recognising digital poverty they had alternative access routes such as telephone triage and face-to-face clinics for patients without internet or smartphones.

The service promoted learning from quality improvement projects and summaries were produced for staff to read and digest in bitesize detail. These included for example, child asthma management, high platelets, topical retinoids, HIV cytology recalls, PSA surveillance, negative FIT results and DNACPR.

The service worked with partner agencies to address future challenges. For example, with local Integrated Care Boards (ICB), Birmingham Community Trust and Public Health teams to align services with wider population health goals. They attended and contributed to multi-agency meetings with social care, mental health services, voluntary sector organisations, housing support, and community outreachteams. They worked closely with community associations in delivering services to patients. They contributed and led on many local initiatives such as population health management projects, health inequality audits, and social prescribing schemes.

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.

Staff told us leaders within the service were approachable and at site level they responded to concerns raised. They suggested that improvement could be made in the visibility of the senior leadership decision makers across all the sites. For example, at times when there were challenges, such as with staff sickness impacting on work pressure. A staff member reported they recognised as a large organisation; it took considerable effort to reach and support all staff equally and they were practising active communication to help bridge this, ensuring feedback and updates were shared effectively.

We saw the leadership team worked with others in their localities and with the wider community and were engaged in the development of primary care services within the local area.
Representatives from the PEG had reported there were openings for further improvement for collaborative support and feedback between themselves and the service provider. The service responded to their feedback promptly, invited the group for a meeting with service leaders, provided direct contact details and demonstrated that they thought highly of the groups input and service support. Following the assessment a face-to-face meeting was held and suggestions and improvement ideas exchanged with a view to future implementation.

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

Cultural concerns had been reported to the Care Quality Commission (CQC) which included bullying and intimidation.We found the service had Freedom to Speak up arrangements in place internally and staff had access to external Freedom to Speak up guardians. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.

Staff had made no reference to bullying or intimidation concerns within the 24 staff CQC feedback questionnaire responses, nor the staff we spoke with both on site and remotely. These comprised of both clinical and non-clinical team members.

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.

Policies and procedures to promote diversity and equality were in place. We saw senior leaders would address concerns related to discrimination. Adjustments had been made to ensure all staff were valued, for example we saw reasonable adjustments were made to support staff.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-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.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. The service held a variety of meetings with their staff and the patient engagement group. This included: a monthly partner meeting, two weekly board meeting, nurse meetings, clinical meetings including pharmacy staff and practice meetings. 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.

The Medical Director was responsible for overall clinical governance and standards. The Operations Lead oversaw activity across all sites. The Care Quality Commission Lead managed compliance, audits, and regulatory preparations. The nursing leadership provided oversight of the nursing team and care delivery, and the PCN and Community Lead coordinated collaboration and outreach efforts.

The service had established governance processes that were appropriate for their service. The minor areas identified during our remote clinical searches and on site were promptly actioned by the leadership team.

Staff took patient confidentiality and information security seriously. Managers met with staff regularly to complete appraisals and performance reviews. Staff could access all required policies and procedures.

Staff told us that their wellbeing was considered, and their views respected, and concerns acted upon. These included, for example, reasonable adjustments andsupport provisions for staff undergoing medical treatment, as well as for those requiring short-term assistance due to family-related responsibilities.
The service ensured there were opportunities for service-wide learning and resultant audit findings were communicated across the sites in a variety of ways. For example, within their quarterly practice development training (PDT) sessions, weekly governance emails, practice newsletters, governance learning ‘Nuggets’ (short, practical updates), practice meetings, partner meetings and audits.

Where themes were identified in any area, the service commissioned audits to test improvement measures. There were numerous audits conducted per annum, these included medicine related audits, health inequalities, access, complaints, significant events, clinical audits and patient feedback. For example: prescribing audits on chronic obstructive pulmonary disease rescue medicine packs was carried out following a significant event. Findings informed changes to prescribing protocols and these were presented at a practice development meeting and circulated within the pharmacy newsletter. A repeat audit was scheduled to ensure changes had become embedded.

Leaders demonstrated excellence in identifying and responding to local needs and harnessing national and local opportunities to the benefit of their patients and the community.

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

The service offered extended access, and flu and covid vaccination programmes. Staff had made adjustments and collaborated and coordinated the service to further support community healthcare services. For example, in the provision of the support provided to care homes and their established direct link access and weekly round meetings centred on the care of those at higher risk of hospital admission. The service had reviewed its patient demographic in detail. The service collaborated with Cancer Research UK and the local mosque to promote cancer screening uptake among Asian men. This initiative formed part of broader quality improvement efforts, including audits and partnerships aimed at enhancing patient outcomes, specifically demonstrated by increased engagement in men’s health cancer screening.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways ofdelivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service had numerous quality improvement plans in place to help drive improvements.

The service had achieved Bronze Accreditation achieved through the RCGP Green Impact for Health Toolkit on, sustainability, their next aim was for Silver Accreditation. This meant the service had:
•Demonstrable reductions in energy usage, paper consumption, and improved waste segregation compliance
•Increased staff awareness of sustainability, reinforced through practice development meeting discussions.
•Positive shift in prescribing patterns, such as a move to prescribe more environmentally friendly inhalers for respiratory conditions like asthma and COPD. A shift away from Metered Dose Inhalers (MDIs) to Dry Powder Inhalers (DPIs) when clinically suitable.
•Improved team morale and engagement via the appointment of a Green Champion.

All staff were encouraged to put forward and test out new ways of working. A quality improvement initiative for supporting people with a learning disability was in progress as a dedicated health inequalities project for 2025 to 2026, focused on improving the uptake and clinical quality of annual health checks for people with a learning disability, with a particular emphasis on cardiovascular disease prevention. This further demonstrated a proactive approach to tackling inequalities and improving long-term health outcomes for this patient group.

The service had ideas in development for future quality initiatives for example, a clinical hub model in the provision of same day improved single point of access, the development of centralised services, in home visiting and phlebotomy services, IT innovations and transformational projects.