Stirling 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

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good. The breaches of regulations relating to safe care and treatment, staffing, and fit and proper persons employed, identified at our last assessment have been addressed. The service is no longer in breach of legal regulations.

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 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. We were told that the culture change had been because all staff were now involved in the way the practice worked. This change was reflected in the positive feedback regarding the culture from staff. We were told this change was because all staff had been involved in the practice plan, leaders being approachable and giving the staff confidence to be honest and supported.

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.

Feedback from staff and external partners was extremely positive about all staff, in particular, the lead GP and the practice manager. Staff reported a change in culture in recent years to one of compassion and inclusiveness. Staff at the practice had nominated the practice manager for a ‘practice manager of the year award’.

The leadership team worked with other practices in the primary care network and was engaged in the development of primary care services within the local area. The feedback we received regarding engagement externally with other practices and the local ICB was positive.

The service fostered a positive culture where people felt they could speak up and their voices would be heard. Freedom to Speak up arrangements were promoted within staff areas. Staff were aware of how to raise concerns.

The service valued diversity in its workforce. Adjustments to support staff had been put in place. Staff feedback was all positive. The leaders 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.

Monthly staff meetings were held for all staff to attend.

The service had clear responsibilities, roles, systems of accountability and good governance. They 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.

The GP and practice manager supported staff and each other. Staff were clear on their roles and responsibilities.

Comprehensive appraisals, competency assessments and one to ones were carried out. The provider had established governance processes that were mostly appropriate for their service. 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 recorded any actions arising from these meetings and ensured they shared these with staff. The staff took patient confidentiality and information security seriously.

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 collaborate for improvement.

The provider worked with other practices within their primary care network to offer a range of services. They met as a PCN Board monthly with a set agenda including operational decision making. Records showed they reviewed how collaborative services such as vaccination programmes and extended access services were working. They had long-standing working buddy arrangements with other PCNs and worked closely with a small number of locums who supported the single-handed GP when necessary.

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. They actively contributed to safe, effective practice and research.

A quality improvement plan was in place. Leaders were committed to learning and improvement. A considerable amount of clinical audit was undertaken to help drive improvement. Improved outcomes for patients were evident from these audits. For example, the care for patients with hypothyroidism had significantly improved. Our search of patient clinical records showed 94 patients were recorded with hypothyroidism and all had received the required monitoring.

The provider demonstrated a commitment to improvement in the wider community by involving the practice in pilot schemes. For example, the practice was part of a pilot in North-East Lincolnshire to transform the local dementia pathway.