Gravesend 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

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. The practice had benefitted from recently revising some of their governance processes to ensure safe practice.

At our last assessment, we rated this key question as requiring improvement. At this assessment, the rating has changed to good.

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.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

An open and honest culture was reported, where staff felt comfortable raising concerns without fear of retribution. The safety and wellbeing of staff were highlighted as one of many priorities, with clear processes in place to address any behaviour that did not align with the practice’s vision and values. Staff also expressed confidence in the leadership’s efforts.

The practice was aware of the projected increase in the local population and was incorporating this into its future service planning.

The service had 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 did so with integrity, openness and honesty.

Staff told us leaders in the practice were approachable and responded to any concerns raised. Staff were positive about working at the practice and told us they felt supported, valued and listened to. There was a strong emphasis on teamwork, professional development, and responsive management. While staff appreciated the open communication and improvements made based on feedback, there were areas for improvement, such as improving internal communication and recruiting more clinical and non-clinical staff. Staff appreciated the limitations of space in the building and welcomed a possible refurbishment. Some staff highlighted challenges in balancing clinical duties and administrative tasks, expressing a need for more protected time to manage both effectively.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had established Freedom to Speak up arrangements. Staff were aware of how to raise concerns. The practice fostered a positive culture where staff felt their voices would be heard and concerns could be raised without fear of repercussions. The availability of a freedom to speak up guardian further reinforced this culture, ensuring staff had a designated point of contact for raising any issues.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place.

Staff reported feeling supported by practice leaders and their peers. They provided examples of the support they had received, including access to learning and development opportunities that contributed to their professional growth. Staff highlighted that the practice promoted a culture of equality, diversity and inclusion.

The service had clear responsibilities and roles. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Lead clinicians had oversight of key risks, including safeguarding, medicine management and clinical practice. The provider also conducted checks on clinicians’ prescribing practice to ensure adherence to safe practice.

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 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. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

The provider met with staff individually or collectively to assess and review performance. Lessons were learned from significant events and complaints, to help prevent similar incidents from reoccurring.

Following feedback during our site visit, the practice strengthened their systems to maintain appropriate monitoring of medicines that required refrigeration.

There were effective systems and processes in place to ensure security of blank prescription forms.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

There was an established Patient Participation Group (PPG). Feedback from members showed the PPG had a strong, collaborative relationship with the practice, with members feeling valued, listened to, and respected. While there were regular efforts to diversify the group to better reflect the practice population, membership remained minimal.

Despite this, the practice’s management and the GPs, were praised for their approachability, empathy, and respect, creating an environment where members feel comfortable raising concerns. We saw examples of improvements made as a result of feedback from PPG members.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Leaders demonstrated a clear understanding of the needs of the practice’s local population, including its demographics and the challenges faced.

The practice had systems and processes in place to support learning, continuous improvement and innovation. We observed evidence of supervision, appraisal and staff training.

Significant events and complaints were used to make improvements. The provider told us learning was shared with staff; documents we viewed and staff we spoke with confirmed this.

Staff we spoke with told us management always encouraged them to develop professionally with courses and training.

The practice had a programme of targeted quality improvement and used information about care and treatment to make improvements.