GP Hub Parkway

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

Managers and leaders were caring and compassionate and had the skills and abilities to run the service. Managers were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles. The service had a vision and strategy for what it wanted to achieve and plans to achieve it. Managers monitored action plans to deliver the strategy. The senior team promoted a positive culture that supported and valued staff. Staff felt respected and supported and were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear. Governance processes were effective and facilitated collaborative working and encouraged and rewarded innovation. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss, and learn from the performance of the service.

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 provider 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 clear focus on addressing health inequalities and reducing barriers to care.

The provider incorporated social values into values, training, and the service delivery model. The organisation was embedded in the local community and involved local voluntary sector groups to provide apprenticeships to help those interested in healthcare enter the sector.

We observed a good degree of support and mutual respect among staff, who told us they felt happy and supported.

The provider had inclusive leaders 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 felt supported and guided by the leadership team. Leaders were available when needed and led by example. They were knowledgeable about the issues and priorities in the service and strived for change and improvement when needed. The senior team focused on staff wellbeing and promoted a culture of good practice, good quality, and safe care and treatment.

Leaders had effective support and opportunities to develop and maintain their credibility and skills. The roles of staff and leaders were clear, and they understood their responsibilities and accountabilities. Staff had opportunities to develop. There was inclusive recruitment and succession planning for the future. The provider had effective recruitment processes and ongoing checks to ensure all staff met the legal requirements to work in the service.

The provider followed national requirements relating to safer recruitment, including background checks and qualification checks on each individual, including locum staff. Locum staff worked with the provider on a long-term basis and the senior team maintained the same standard of recruitment and development records as they did for permanent colleagues.

A reception team leader was always available on site and a supervisor worked between both GP hub locations. They split their time equally between sites and increased presence at 1 location if needed based on staffing pressures or demand. A manager was on call at all times the service was in operation.

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

Posters explained the freedom to speak up guardian (FTSUG) role and encouraged staff and visitors to report concerns. This system offered people the opportunity to make anonymous concerns. All staff said they understood the role of the FTSUG and their role. While the team viewed this service as a positive resource, everyone we spoke with said they would discuss any concerns with the senior team. They described a transparent, honest culture based on trust in which they felt confident any issues would be addressed.

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

Diversity and inclusion were embedded across all aspects of the service, including in new staff onboarding, training, and governance systems. All staff we spoke with said they felt recognised and included by the provider and appreciated a diverse working environment.

The provider had clear responsibilities, roles, systems of accountability, and good governance. Staff 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.

Staff had time and resources to undertake effective governance and manage risk. There was a good range of accurate and timely data and information available to understand performance and quality and improvements were made as needed.

The senior team managed a risk register that had 14 active risks at the time of our inspection. Risks reflected the estate and the impact of health inequalities in the region, such as drug-seeking behaviour and high levels of safeguarding need.

The senior team held bi-monthly meetings to discuss and address key areas of performance, risk, audit, culture and workforce. Minutes showed the team addressed areas of concern and took actions to learn and improve. They made changes when needed to improve the service. Managers recognised and celebrated good practice.

The clinical lead used a ‘1% audit’ to measure the quality of care and outcomes. This approach involved observing 1% of the clinical appointments of each GP and reviewing subsequent notes, referrals, and prescribing. The provider had a target of 80% compliance with expected standards. The clinical lead took action to improve poor performance. Results from the previous 12 months demonstrated consistently good practice, with over 90% of the audits meeting or exceeding the target.

The service had a business continuity plan that focused on keeping people safe while minimising disruption to the service.

The provider understood their duty to collaborate and work in partnership. Staff shared information and learning with partners and collaborated for improvement.

Staff understood how some patients could be disadvantaged by local commissioning arrangements and systems that made it difficult to secure appropriate care. The provider worked with community and regional partners to reduce the impact of these barriers. For example, the service liaised with GP practices to stock wound dressings needed daily by some patients who could not access their regular practice as frequently.

The GP hub team worked closely with the NHS trust estates team to manage risks and challenges in the building. Staff from both organisations said they worked well together and appreciated the support of each other. Other providers on site said their own patients sometimes presented in need of medical support when they were closed and the GP staff had made sure they were seen. They said this reflected a high standard of healthcare ethics from the hub team.

The senior team used the national standard health professional feedback (HPF) form to raise issues with the NHS 111 service where referrals had been inappropriate or declined. The team used the HPF process to manage risk by seeking collaborative investigations of incidents relating to 111. For example, the service had received a referral at 2am, when it was closed, for a patient with immediate mental health needs. Staff took immediate steps to help the patient once the service opened, and the senior team worked with 111 to identify causes and reduce further occurrence.

The clinical lead worked across Croydon Integrated Urgent Care and so had oversight of GP hubs and an out of hours service. This improved integration in the system through shared learning, incident management, and patient outcome monitoring. Staff also used the information to maintain an up-to-date understanding of regional health needs and pressures.

The provider 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. They actively contributed to safe, effective practice.

The senior team implemented a ‘skills and drills’ practical training programme. Using an ad-hoc approach, the programme enabled the senior team to react to incidents, events, or complaints, and provide micro simulation sessions to staff. This had included managing incidents in the waiting room, managing a sick patient, and recognising a stroke.

Supervisors met quarterly with the practice managers from the other GP services in the building, along with other teams such as district nurses and ultrasound. This was a collaborative approach to solving challenges and issues and teams used this approach to discuss changes in trends relating to demand.

Staff had successfully delivered a community engagement event during the school holidays. The event was timed to coincide with periods of highest demand and reflected the team’s good understanding of local socioeconomic challenges and health inequalities. Staff identified a number of unmet needs and conditions amongst people who attended and signposted people to the most appropriate sources for help. They also worked with people to improve their understanding of the local NHS system and coordinated discussions with health visitors and district nurses to help people understand key differences.