St Georges Medical Practice

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• 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 looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment, we rated this key question as outstanding. At this assessment, the rating has changed to good. Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.

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 service had a shared mission statement, philosophy and set of values, which was shared with all staff are part of their induction and displayed around the building. The service aimed to provide high quality, safe and compassionate care in partnership with their patients, to seek to continuously improve the service offered and offer an excellent training environment. Staff were positive about culture within the service and described it as open and transparent.

The service was popular within the local community and consequently the patient list size was continually increasing. Although the leaders were willing to expand the staff team to accommodate the increase in registered patients, they were at full capacity within the building in addition to staff working remotely. The leaders were in discussions with the local Integrated Care Board to try and address these challenges.

The service had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The service had a stable and very experienced leadership team. Staff spoke positively about the leaders, that they were approachable and responded to any concerns raised. We saw the leadership team worked with other practices in the primary care network and were engaged in the development of primary care services within the local area.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. Staff were aware of who the freedom to speak up guardian was and what whistle blowing was. The service had established Freedom to Speak up arrangements with the Integrated Care Board. Staff were aware of how to whistle blow and who the Freedom to Speak Up Guardian was and what their role was in supporting staff. Staff felt that they could speak up and were confident their voice would be heard and acted upon.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They mostly acted on the best information about risk, performance and outcomes. The service had not acted on a previous safety alert as we identified 3 slatted window blinds in the waiting room which were a potential risk as the loose pulley was not fixed to the wall to prevent potential strangulation of children. The service provided evidence following the assessment that these blinds had been removed. The action plan developed following the external infection prevention and control audit indicated that a number of actions remained outstanding. The system for tracking prescription stationery was not effective. Following our assessment the provider forwarded to us an updated process outlining the changes that had been introduced.

Leaders and managers supported staff, and 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 governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks.

There were governance processes appropriate for the service. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborate for improvement. The provider worked with other practices within their primary care network (PCN) to offer enhanced access appointments. Staff were encouraged and supported to attend local forums which provided networking opportunities with other services within the primary care networks. These included monthly practice manager and practice nurse forums, and regular reception, secretary and carers champion meetings. The practice manager also attended meetings organised by the local medical committee.

The service had an active Patient Forum. The service invited all patients aged 16 and over to the annual general meeting (AGM), which was well attended with around 80 participants in 2024. Members of the Patient Forum supported the service to consider diversity issues such as wheelchair access and a dementia friendly environment. Members of the Patient Forum were also active within the local community, through involvement in the locality patient group, Rushcliffe Active; on the board of the local ‘breath-easy’ patient group for respiratory illness; and on the board of Healthwatch. Updates from Patient Forum members was shared with the service as appropriate.

There were processes in place to work in partnership with key organisations and agencies to support the provision of care and joined up working. For example, district nurses, community matrons, specialist nurse such as respiratory and heart failure nurses and the ‘care home team’. Feedback from representatives of 2 care homes where the service provided care and treatment was very positive about the GPs especially around their responsiveness to requests and queries.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service was a well-established training practice for GP trainees, medical and nursing students. Systems were in place to support trainees and students during their placements. The service used learning from significant events and complaints to continually improve the service they provided.

Staff participated in quality improvement work. Staff told us about the positive impact following quality improvement work to identify potential barriers to the uptake of cervical screening. The service had achieved ‘Research Ready’ status with the Royal College of General Practitioners.