Resilience Medicine Clinic Ltd

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 in the Well-led key question and found areas of good practice. We found effective governance and risk management systems and processes. We saw information was used effectively to monitor and improve the quality of care. Staff reported that leaders were visible and approachable. There were named leads in place for key areas and staff were clear about their roles and responsibilities. Leaders had an understanding of the needs of their patient group, the challenges of prescribing medicines and the priorities for their service.

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.

Staff were aware of the shared vision and values which was supported by a strategy and supported each other to achieve this. Leaders demonstrated a listening culture that promoted trust and understanding between all members of staff which focused on learning and improvement. All staff were aware of the services vision and values. The vision was for people with complex chronic illness conditions that have not responded well to standard pharmaceutical therapy alone to be able to improve their quality of life, their resilience and in many cases their symptoms. In cases where symptoms were going to deteriorate due to underlying illness; they tried to always help improve the quality of life and support care decisions. Wherever possible, the service tried to empower patients to optimise their use of NHS services.

All staff were required to complete Equality and diversity training to better understand the needs of staff and the practice population. Leaders had weekly meetings to ensure effective governance through a set agenda and implemented change when appropriate.

Staff told us that the leaders were knowledgeable about issues relating to these clinics and were clear about how to improve the quality of the service. The leadership had encouraged openness and honesty in order to develop a positive clinic culture which positively impacted patient care.

The leadership team told us they tried to lead by example by modelling the culture of the clinic which was also embedded in the Operational Policy. They were knowledgeable about their managerial role and prioritised the quality of the service. They provided appropriate support to all staff through the training that was offered.

Staff told us they were able to raise concerns with the management team due to the open culture at the clinic. Leaders told us they demonstrated honesty and transparency and encouraged staff to raise concerns through various routes.

The clinic had a whistleblowing policy which also signposted staff to external organisations should they not feel comfortable to raise concern internally. They also had various methods for staff to speak up such as a suggestion box, regular meetings, supervisions and appraisals.

Leaders ensure there were various proactive ways to engage with and involve staff. They focus on hearing the voices of all staff and said they worked hard to ensure all staff felt included and never marginalised. Staff felt empowered and were confident that their concerns and ideas resulted in positive change to shape the clinic and created a more inclusive organisation.

Leader ensured all staff could be heard through various routes of communication such as, staff supervisions, appraisals, meetings and were approachable at all times through an open door policy.

Interviews with staff and leaders demonstrated there were clear governance arrangements that supported staff to deliver good quality care. Staff we spoke with were clear about their roles and responsibilities. Staff also told us they would raise feedback, suggestions, and concerns when required.

There were policies, processes, and systems to support governance and management of the clinic which were overseen by the management team. There were regular staff meetings during which issues significant to the delivery of clinical care was discussed and reviewed. Senior staff informed us there were weekly clinical management meetings involving the senior management team. In addition, the service held weekly complaints and prescribing meetings. Further, clinicians’ patients’ decisions meetings were held daily. The service had quarterly multidisciplinary meetings meetings to discuss any clinical issues or developments. Clinical incidents were discussed and recorded in their Incident report form and their clinical events log, which staff can review retrospectively and update as necessary. Complaints, significant events and safeguarding processes were clearly understood, and all staff knew who to go to in the event there was a concern being raised. We found the appropriate meetings were taking place to ensure governance processes worked and quality was being delivered. There were arrangements for the availability, integrity and confidentiality of records and data management systems. Information was used effectively to monitor and improve the quality of care.

We were unable to gather patient feedback, however, the service requested feedback from patients to review the quality of care provided. Although the service did not question patients directly about consent, the feedback collected showed the majority of patients were satisfied with the service and had no concerns regarding consent.

We found staff and leaders were open and transparent, and they collaborated with all relevant external stakeholders and agencies such as patients NHS GPs.

We were unable to gather feedback from partners for this assessment.

The provider had policies and procedures in place that ensured that prior to being taken on by the clinic, they had to receive confirmation from the patients NHS GP that they met the criteria for the clinic. The management and leadership team met weekly to discuss challenges within the clinic and ways in which they can improve the quality of care to better serve the clinics population and improve relationships with similar external agencies.

The clinic demonstrated a positive learning environment that was inclusive to all staff, which improved the working environment and care provided to patients. Staff told us about the mandatory training they had to complete and about the various learning opportunities they had to further develop their skill set so they could pursue other roles.

All clinicians had to complete formal medicines specific training both external and internal prior to being employed by the clinic. All staff were allocated protected time to develop their skills around improvement and innovation through various routes which included reflective practice. There was a clear strategy for how to develop these capabilities and staff were consistently encouraged to contribute to improvement initiatives such as research papers and clinical trials. Any learning from significant events would be shared in an anonymized version of that case with the team, and of course with the patients NHS GP. The service took a holistic view while still remaining very evidence based. They had put together mini courses that were video, text and slide based that were called micro learning lessons that patients go through to help them with the lifestyle aspects of their program. The service also specialised in functional medicine testing, and they carried out comprehensive stool analysis, microbiome testing and looked at lifestyle modifications. This included diet, use of probiotics and supplements based on test results for patients. They kept a record of these to help track the quality of improvements. They were also developing a mobile application so that patients could track their mood, energy, and clarity over time.