Preston Hill 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

We found that the service was well-led because the leaders inspired staff to provide high quality care that met people’s complex needs. The practice leaders drove strong collaboration with external stakeholders to improve the quality of care and patient experience. Staff told us they received excellent support and encouragement from colleagues and leaders with opportunities to develop and there was an integral focus on learning, research and improvement that was evident across all aspects of the service.

This service scored 86 (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 told us that there was a strong shared direction and culture. This was consistently described in terms of working to provide the best quality care, tailored to patients’ individual needs and choices.

The practice had a motto, mission statement, vision statement and values which emphasised the importance of involving patients to provide good care. This information was shared on the practice website. The leaders and staff were able to describe how these aims and values underpinned their day-to-day work. The provider had also developed a ‘diabetes manifesto’ setting out their ambitions and provision for people with diabetes or at risk of diabetes.

Staff reported that leaders were visible and approachable. Leaders demonstrated that they understood the challenges to quality and sustainability and had identified the actions necessary to address these challenges. The service was led by the lead GP with the support of the practice manager and other members of the team. Staff were wholly positive about the quality of leadership at the practice, for example, describing the lead GP as ‘brilliant’ and ‘inspirational’. Some staff told us they had re-joined the practice after working elsewhere because of the positive working culture and focus on patient-centred care that the leaders fostered.

There were processes in place to support effective leadership, for example, an ‘open door’ policy and regular meetings. Staff had access to appraisal and supervision appropriate to their role.

Staff informed us there was good communication within the service and they felt able to raise concerns without fear of retribution.

Freedom to speak up was covered in induction and the required training that all staff completed. The Freedom to Speak Up policy included independent contacts to whom staff could raise any concerns.

Staff we spoke with did not identify any concerns around workforce equality, diversity and inclusion. They told us the practice was friendly and inclusive.

The practice had a policy on workforce equality, diversity and inclusion and equality was covered in other relevant policies, for example staff recruitment. Staff were required to complete training on equality and diversity. The practice premises were physically accessible.

Leaders and managers supported staff and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews.

The provider had established clear governance processes and clear lines of accountability. 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 clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took action to protect patient confidentiality and information security. The provider reviewed, evaluated and audited the service provided. Performance was objectively assessed against guidelines, national and local targets and by benchmarking against other practices. Results were discussed and actions re-audited to assess improvement. Staff training was monitored and all staff were up to date with required training.

The provider had sought the views of patients and implemented initiatives to meet the needs of their patients. For example, they had recently set up a donation bank for essential baby items to support parents and children in difficult times.

Leaders were described as transparent and proactive in ensuring a learning culture was embedded to improve the service. The practice shared information and learning with partners so that wider improvements could be made at a local level. The practice had a Patient Participation Group (PPG) which met annually. The last meeting in September 2023 was well attended and allowed the practice to share updated information regarding the service.

Partners spoke positively about the practice’s involvement in partnership working and collaboration to provide an effective and responsive service.

Practice meetings covered clinical and non-clinical updates and notes were circulated after the meeting.

There was a strong focus on continuous learning and improvement at a practice level and within the local primary care network. Staff consistently told us this was a positive aspect of working at the practice and identified the lead GP as an effective driver of improvement who led by example.

The practice made use of learning events, incidents, feedback and complaints to drive continuous improvement. The practice displayed a poster in the waiting area with a summary of feedback received from patients and actions taken as a result . The provider used clinical audit and evaluation extensively to assess and improve its performance in a wide range of areas. For example: we reviewed audits covering the prescribing of specific medicines and combinations of medicines and the management of long-term conditions. The provider also audited processes, for example it had reduced its ‘exception reporting’ through auditing (that is, the number of patients coded as ineligible for certain interventions) and the lead GP carried out regular audits of clinical records. Additionally, the team reviewed each new case of cancer and all deaths to understand potential points of learning. The provider was an active participant in research studies relevant to the local population sponsored by the National Institute of Health Research. The provider had achieved high levels of patient participation in research studies and had received a regional practice award in recognition of this work.