The Medical Centre Crabbs Cross

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

Leaders had governance processes in place but found improvements could be made. Clinical audits were completed to ensure patients were safe however audits in areas such as staff surveys lacked analysis and outcomes. Staff were clear on their individual responsibilities and knew who was accountable for each aspect of the service but would benefit from supervision from leaders to have the opportunity to discuss the impact of this on their role. Staff were not fully supported to complete training and this impacted on their wellbeing.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders and staff were committed to providing safe care and treatment. However as busy smaller practice advice and guidance for staff was often shared in an informal way which was not recorded. This meant not all staff received the same information.

Leaders had a set of values based on quality and safe care. These were not in a policy, and it was not clear how this vision was shared with staff. However, staff demonstrated these values in the way they treated and cared about the outcomes for patients.

Staff put the needs of patients first which meant there was not always enough time to complete training and administration tasks within their working hours. Staff who attended training would benefit from follow up and support from leaders to put new skills into practice.

The practice had no evidence of a leadership development programme. However, leaders told us they had recruited an additional salaried GP and increased the clinic provided by their regular locum GP as they had not been able to find an additional partner GP to work in the practice. The practice had an appropriate recruitment policy in place. Staff recruitment files demonstrated the policy was followed, and good practice was used during recruitment.

Staff felt there was not always time to speak up as they prioritised patient care. They knew the process for raising concerns with other organisations such as CQC if they needed to.

The practice did not have a policy for speaking up. This would benefit both leaders and staff to have a process in place so staff would be able to do this if required.

Staff felt included in their smaller teams within the practice but did not always feel there was equality in the way the workload and tasks were allocated. Leaders had tried to give staff their own responsibilities within the practice, but lack of dedicated time made it difficult for staff to complete these.

Leaders did not have a policy in place for workforce wellbeing. This type of policy would enable staff to know what support they can ask for and help to form discussions around workload and responsibilities within the practice.

Staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff in regular team meetings and completed annual appraisals with them. Clinicians received regular supervision although this was not always recorded. Other staff did not receive regular one to one time with managers to follow up from their appraisals so did not have the opportunity to achieve actions from this. As a smaller busy practice staff did not always have protected time to complete training and administration duties and would benefit from having time for this.

Leaders had processes and policies in place for completing regular audits. While clinical audits were completed, actions for other audits such as the staff survey were not always recorded so it was not possible to see where improvements had been made. Staff took patient confidentiality and information security seriously.

Patients liked being able to attend a smaller practice where staff knew them and their local community well. This gave them the opportunity to be referred or signposted to local services where they could receive additional support.

Leaders worked with a wide range of partners within their local community. These included mental health services, community physiotherapy, community nursing teams and drug and alcohol services. Staff made regular referrals to specialist clinics for patients who were pre diabetic and to social prescribers. This service connects people to activities, groups, and services in their local community.

Feedback from partners was positive about the service. They found staff to be approachable and open to discussing concerns they had for patients they were both treating. This was particularly useful for patients in care and nursing homes, so they received a joined-up service.

Leaders had policies and procedures in place, so staff knew who to refer to and when to do this. Reception staff were trained to recognise when to signpost patients to more appropriate services such as the community pharmacy for their treatment.

Leaders had made improvements to the environment, the telephone lines and the website. Staff were positive about the changes which leaders had made.

Leaders were working on the general practice improvement plan. This provides free national support to GP practices to help improve care navigation processes. Leaders were working to improve patients access and care, preventing illness and tackling health inequalities in their local community.