Field Street Surgery

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

Staff understood their roles and responsibilities and the practice involved partnerships and communities to encourage development of the service. Leaders and management acknowledged the pressure they were under due to changes of staff and making the required improvements to governance at the practice. For example, prior to our assessment leadership had identified concerns in relation to a backlog of summarising of patient notes, oversight of staff records and clinical oversight. The culture of the practice due to staff changes was fragile and whilst the team continued to work together, we were concerned over the sustainability of the current processes in place. The practice took immediate action in relation to concerns we raised and were able to provide assurance they were aware of this risk and a plan for the future improvements.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were aware of the shared vision and strategy and supported each other to achieve this. Staff told us although there were staff changes the team worked cohesively to promote patient care.

The provider held regular practice meetings where all staff were invited, this promoted them to have a voice and feel involved in the vision of the practice.

Staff mentioned various routes in which they could raise concerns to leaders and whilst most were happy with outcomes, some staff told us they didn’t feel their concerns were always treated with respect.

The leaders acknowledged the recent changes and how it could impact staff. They held regular meetings, conducted wellbeing questionnaires and annual appraisals to promote wellbeing and make changes where needed.

Staff were aware of the freedom to speak up guardian within the Primary Care Network (PCN) and were able to raise concerns externally to the Integrated Care Board (ICB) and Care Quality Commission (CQC).

The practice had a freedom to speak up guardian within the PCN and signposted staff to the ICB should they not feel comfortable to raise internally. The practice had various methods for staff to speak up such as regular meetings, appraisals and leaders were approachable at all times.

Staff told us there were regular practice meetings in which all staff were involved, staff felt their characteristics were protected and they felt valued in the team.

Leaders ensured all staff could be heard through various routes of communication such as staff surveys, appraisals, meetings and being approachable at all times through an open-door policy.

Interviews with staff and leaders demonstrated there were governance arrangements that supported staff to deliver care and treatment. Staff we spoke with were clear about their roles and responsibilities. Staff also told us how and who they would raise feedback, suggestions, and concerns to when required. Leaders raised concerns around current changes in staffing and identified further support was needed. Whilst there were plans in place for improvements, we couldn’t be assured that current working arrangements were sustainable.

Policies, processes, and systems to support governance and management of the practice were managed by the GP partners and the management team. There were regular meetings during which issues significant to the delivery of clinical care were discussed and reviewed. The practice generally had good oversight of governance arrangements. However, due to staff changes it had put pressure on the leadership team. We found that some governance arrangements were lacking consistency. For example, through our review of safety alerts we identified patients at risk; lack of detail on prescriptions when prescribing medicines; complaint information wasn’t consistent throughout the process; safeguarding adults policy wasn’t present in paper form but available electronically; staff files were not completed in one place for consistency and there was a backlog of patient records to be summarised. The practice were in the process of reviewing the business continuity plan and were responsive to our findings and assured us this would be reviewed and completed as a priority.

Conversations with the Patient Participation Group were mainly positive in terms of the relationship between the practice population and the provider. The provider had communicated well to help guide changes in the phone and appointment system at the practice.

We found staff and leaders were open and transparent, and collaborated with all relevant external stakeholders and agencies.

Staff and leaders engaged with people, communities and partners to share learning with each other that resulted in continuous improvements to the service.

The management and leadership team met weekly to discuss challenges within the practice and ways in which they can improve the quality of care to better serve the practice population and improve relationships with external agencies. This was then discussed during the monthly practice meetings for further discussions.

Staff told us about learning opportunities they had been given to further develop their skill set and branch into further roles.

Staff were supported to develop should they wish to. Staff had protected time in their diary to complete training or projects, the practice leaders were enthusiastic in regard to developing their workforce.