Billinge Medical Practice

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 assessed all the quality statements from this key question. Our rating for this key question has improved from inadequate to good. The provider had worked to a detailed quality improvement/action plan to ensure the concerns highlighted following our last inspection had been promptly addressed so as to improve the care and treatment provided and improve outcomes for patients. We found the provider had reviewed and improved the arrangements for governance and medicines management. There was an inclusive and positive culture of continuous learning and improvement. Staff understood their roles and responsibilities and the limitations of these and the lines of accountability. Staff told us they felt well supported in their role and there were clear expectations about the training they were required to undertake. Staff told us they felt confident to speak up and that action would be taken to address any issues they raised. Systems were in place for monitoring and managing the performance of staff. There were appropriate arrangements for the availability, integrity and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care. The service was well managed, and leaders demonstrated that they understood the challenges to quality and sustainability and had taken actions necessary to address them.

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.

There was a shared vision across the leadership and staff team to provide a good quality service that was responsive to the needs of patients. This included an understanding of the challenges and the needs of the patient population. Leaders and staff could demonstrate positive changes the practice had made to improve the services provided to patients and to improve their experience of working at the practice. Staff told us the culture of the service was positive, open, transparent and supportive. There were clearer responsibilities for clinical and non-clinical staff and communication had improved. Staff demonstrated an understanding of equality, diversity and human rights, and they prioritised good quality and compassionate care. Equality and diversity issues were identified, and equality and diversity were actively promoted.

Improvements had been made to the processes for communication amongst the staff team. Regular staff meetings were held, and staff were involved in discussions and decisions about the service and service development. Clear improvement plans were in place to demonstrate the challenges experienced and how these were to be addressed.

Staff told us they felt supported by the leadership team. Staff reported that managers were visible and lead by example. Staff told us the culture of the service was open and the managers had an open-door approach. They said their colleagues were supportive and they were confident and comfortable approaching the management team for any reason. Staff told us teamwork was good and that they enjoyed working at the practice.

Leaders had the experience, capacity, capability and integrity to ensure the practices’ vision could be delivered, and risks were well managed. Leaders were knowledgeable about issues and priorities that could impact the quality of the service. The provider monitored and acted upon data about outcomes for patients. They made improvements when required. The provider had appropriate staff recruitment procedures in place. Leaders encouraged professional development. Since the inspection in September 2023 the provider had made a number of improvements to the service, and they had sought assistance from outside organisations as needed. At this and at an assessment in April 2024 improvements were evident.

Staff told us the management team were approachable and supportive and that there was a culture of speaking up where staff felt they could raise concerns and would be supported to do so. Staff were confident that if they reported concerns then they would be addressed, and appropriate action would be taken. Staff knew how to access policies and procedures and nominated people to support them to speak out such as the whistleblowing policy and the Freedom to Speak Up Guardian.

The provider fostered a positive culture where people felt that they could speak up and that their voice would be heard and acted upon. Staff and leaders acted with openness and transparency. There were regular opportunities for team meetings and appraisals where staff were encouraged to make suggestions, raise issues or concerns for their personal and professional development or developments to the service.

Leaders promoted equality, diversity and inclusion. Staff felt leaders would take action to prevent and address bullying and harassment for any staff, including those with protected characteristics under the Equality Act and those from excluded and marginalised groups.

Staff had completed training in equality, diversity, and inclusion and were aware of supporting people with protected characteristics such as age, gender, religion, or disability. Reasonable adjustments were made to support staff to carry out their roles. The provider supported all staff to meet their roles and responsibilities, including flexible working arrangements.

Staff and leaders told us that they were clear on their individual roles and responsibilities. They said there was good communication, and they attended regular meetings which they found useful. Staff could access all required policies and procedures. Staff took patient confidentiality and information security seriously. Staff told us that governance overall felt improved, and they were better supported by this change, for example, they now had access to a number of standard operating procedures which clarified their roles and responsibilities.

Staff and leaders told us that they were clear on their individual roles and responsibilities. They said there was good communication, and they attended regular meetings which they found useful. Staff could access all required policies and procedures. Staff took patient confidentiality and information security seriously. Staff told us that governance overall felt improved, and they were better supported by this change, for example, they now had access to a number of standard operating procedures which clarified their roles and responsibilities.

Overall, feedback from people who used the service was positive. We met with representatives of the Patient Participation Group (PPG) who told us about their commitment to improving services for patients by working closely with the provider. The PPG met with the provider on a regular basis. They told us that they were kept informed about changes and listened to. They gave us examples of the changes made at the practice as a result of PPG feedback. The PPG praised the provider for the changes made to the service since the last inspection. This included, new telephony systems, the increased availability of appointments (both urgent and routine), increased staff with varying roles and improved integration with the pharmacy. The PPG had undertaken a patient survey in July 2024 which had 536 respondents. The results indicated overall positive feedback from patients about access and care and treatment.

The provider understood their duty to collaborate and work in partnership with other stakeholders. Staff and leaders told us how they worked in partnership with key organisations to support care provision, service development and joined-up care.

The practice worked closed with the local Primary Care Network (PCN) and the Integrated Care Board (ICB) who spoke positively about the practice and the work they had undertaken since our last inspection.

Staff and leaders engaged with people, communities and partners and used local networks to identify new or innovative ideas to improve outcomes and the experience of people who used the service.

Staff told us that there was a focus on continuous learning and improvement across the service. Leaders encouraged staff to speak up with ideas for improvement and innovation and invested time to listen and engage.

The provider worked in partnership with stakeholders to improve services for people within the locality. This included being involved in ways to deliver equity of experience and outcomes and providing good quality care and treatment for people. There were processes to ensure that learning was shared when there were incidents and action was taken to improve the service and prevent a reoccurrence. Leaders had made improvements to the service in relation to the governance systems and the management of medication following our last inspection. Systems for seeking feedback from people who used the service, acting on this and evaluating the actions taken had been implemented. Clear improvement plans were in place for making further changes.