The Firs 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 found there was a continuous learning and improvement based on meeting the needs of people who use services and wider communities. Leaders understood local population issues, and the challenges and priorities for their service. Leaders proactively supported staff and collaborated with partners to deliver care that is safe, integrated, person-centred and sustainable, and reduced inequalities. The practice had a shared vision, strategy and culture.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The leaders explained they had taken over the practice June 2023 and they had worked with the staff to find a shared direction and culture. The leaders were a GP Partnership providing primary care at scale covering 5 GP sites across Northeast London covering 48,000 residents and employing 150 staff. They said they were a value driven organisation, passionate about its workforce and its ability to serve its community through the provision of high quality and accessible primary care. They said they embraced technology, automation, back-end centralisation and an optimised workforce sharing best practice and leveraging economies of scale. During the assessment staff told us that there had been improvements and leaders were now approachable and listened. The practice had carried out an independent staff survey in June 2024, 15 out of 29 staff responded, all agreed they had a clear understanding of the practice vision and strategic goals. Staff surveyed believed the practice vision drove the decisions made, the work they all did and how they provided care and could easily see how their work contributed to the strategic goals of the practice.

The practice had an organisation chart, which clearly explained the chain of management at the practice. The leaders held quality and safety and Board meetings monthly to review progress, staff had been allocated roles and had job descriptions in place. Staff were offered regular review, supervision and appraisal. The practice had developed a mission statement which was providing high quality care for the community with integrity, compassion and trust. We saw a detailed business plan, with clear strategies and objectives for the future.

The practice had carried out an independent staff survey in June 2024, 15 out of 29 staff responded, all agreed they felt supported by their manager and the partners were aware of the practice was running,, most flet the partners valued the contribution of the employees and most thought the partners cared about their employees. The leaders explained all of the partners worked at the practice during the week and the practice had a lead GP who worked full time. The leaders explained the practice offered flexibility in the hours staff worked to enable staff to meet their cultural and caring responsibilities. The staff we spoke with and who completed a questionnaire stated they felt supported by the leadership team.

The practice had put in place job descriptions for all staff and had ensured staff were aware of their roles and responsibilities. A review of a sample of staff files found the practice was following an improved recruitment process. The partners explained that they had a succession plan in place for the practice. Staff had access to training and development and a employee assistance programme.

The practice had carried out an independent staff survey in June 2024, 15 out of 29 staff responded, all agreed their manager encouraged them to raise issues without fear of getting into trouble and most stated that the partners listen to staff views and ideas and their was a positive culture at the practice. The staff we spoke with and who completed a questionnaire stated they able to make any concerns known.

All staff had completed their whistleblowing training and there was a whistleblowing policy in place last reviewed May 2024. The practice had a freedom to speak up guardian for staff to speak to.

The practice had carried out an independent staff survey in June 2024, 15 out of 29 staff responded, all agreed the practice valued the diversity within the workforce and most agree the people in my practice treat each other with respect, regardless of their role. Most agreed that the partners listened to staff views and ideas, The leaders explained that they provided flexible working arrangements and time for staff to follow their religious and cultural beliefs. Staff had access to an employee assistance programme, continual professional development and support and mentorship, rewards and recognition, and celebrations.

The practice had the system and policies in place to enable staff to raise their concerns, staff had the opportunity to raise issues at meetings, supervision and appraisal, and the staff survey. Staff had completed equality and diversity training and learning disability awareness.

The leaders had taken over the practice June 2023 and had put a new governance system in place. This included a clear leadership structure, with senior management available and actively engaged with the team. They held quality and safety, finance and Board meetings where the management and sustainability were reviewed. The leadership team had recruited to new positions at the practice and had sought staff and patient views about any changes they had made. The practice had carried out an independent staff survey in June 2024, 15 out of 29 staff responded, some felt there were sufficient staff to cope with the workload and most felt they had the right resources and tools available to support the team and their jobs well.

The practice held monthly quality and safety which reviewed compliance, and significant events, training and audits. Also, a monthly Board meeting which reviewed risk, patient safety and quality improvement training and development and the findings of the quality and safety meeting. Monthly administration meetings and clinical meetings. The practice used technology to enable them to continually monitor their performance, for the management of health conditions and access to the practice. The leaders explained they used this information to continually assess whether they had sufficient staff skilled staff to provide a safe service, A major incident plan was in place.

The national GP patient survey carried out from January to March 2024 had 90 responses, which demonstrated 915 per cent of patients stated their needs were defiantly or to some extent met. We were provided with patient feedback from local Healthwatch they had gathered from social media and the provider website from July 2023 to April 2024, found 37 positive and 10 negative comments. The positive comments covered the booking system, the quality of the practice, and reception staff. The negative comments were regarding practice administration and medicines. The practice submitted their own unverified survey in July 2023 which had received 278 responses. This found 73% of patients described their experience at the practice as fairly to very good. We spoke with a member of the patient participation group who told us there had been significant improvements at the practice.

The leaders explained how they engaged with patients. For example, they had a quality improvement project where they held 5 engagement sessions with the patients when they changed the online to the practice to a digital hub and they had carried out patient survey. In addition, they held patient participation meetings, every where patients could contribute their views and had a monthly newsletter to inform patients of any changes.

The leaders explained they had a multidisciplinary and anticipatory team meetings team monthly meetings to discuss and improve outcomes for people with complex needs and a three-monthly meeting with the health visitors to discuss child safeguarding. The practice was actively involved in their local primary network, where they worked with other practices to improve the local health inequalities. The practice was involved in developing diabetic workshops, this was led by the social prescriber and health and well being coach (in collaboration with diabetes specialists and representatives from Diabetes UK).

The practice worked closely with local practices to identify and improve local health inequalities. They had sought patient feedback to any changes at the practice through surveys and engagement sessions. Patient deaths were also reviewed at clinical meetings.

The practice has been involved in forming its own multi-agency action group, which was made up of health partners, and the local authority. This had delivered GP pop up clinics, which provided access to social prescribers, GPs, pharmacists, dentists, nurses, and local vaccination teams together with over 20 other voluntary, community and social enterprises partners. In 2023 the practice was involved in developing diabetic workshops, this was part of a targeted quality improvement program, aimed at supporting patients with diabetes, one of the largest cohorts of long-term health conditions at the practice. The primary objective was to assist patients to better manage their diabetes through enhanced education and lifestyle modifications. This was led by the social prescriber and health and well-being coach (in collaboration with diabetes specialists and representatives from Diabetes UK The practice had implemented a new GP-led total triage model supported by AI-powered triage software, delivered through an innovative digital hub and centralised call centre. The hub had GP’s co-located in a multidisciplinary team hub setting, supported by GP assistants, care navigators, pharmacists and paramedics who triaged and triaging and signposted all requests for support at the first point of contact through a single point of access virtual front door. Staff were supported by a clinical and non-clinical triage guide and their work was reviewed three monthly. The leaders explained that the practice was the 5th lowest of all 40 GP practices in Waltham Forest or in-hours 111 utilisation and the lowest in the whole borough for accident and emergency attendances per weighted list size, prior to this Firs was amongst highest for A&E attendances

The practice had quality and safety, Board meeting monthly and pan practice meeting quarterly to review the strategic direction, values, team building, and update on organisational priorities.