Practice Plus Group - NHS 111 London

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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 found that the service was providing well led services because the service had a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients. There were clear responsibilities, roles and systems of accountability to support good governance and management. There were clear and effective processes for managing risks, issues and performance. The service involved patients, the public, staff and external partners to support high-quality sustainable services.

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.

Leaders at the service detailed a clear vision and values for the service. These were shared with staff who they told us had input into the direction of the service. Staff told us that they felt engaged by leaders at the service. They told us that they were listened to, and detailed examples of how they had contributed to the development of the service. Staff were aware of and understood the vision, values and strategy and their role in achieving them.

There was a clear vision and set of values, which we saw that the service acted on. The service had a realistic strategy and supporting business plans to achieve priorities and monitored progress against the strategy. The strategy was in line with health and social priorities across the region. The provider planned the service to meet the needs of the local population. Staff who worked away from the main base were engaged in the delivery of the provider's vision and values.

Staff told us that leaders at all levels were visible and approachable. They told us that they worked closely with staff and others to make sure they prioritised compassionate and inclusive leadership. Senior management was accessible throughout the operational period, with an effective on-call system that staff were able to use.

There were clear lines of responsibility to support capable and inclusive leadership.

Leaders at the service told us that the organisation considered it important that the voice of staff could be heard. Staff told us that they felt comfortable raising concerns, and were confident that the leadership of the organisation would act on them.

The service had a freedom to speak up guardian in place at the service. There was also a comments box in place at the service, and notices were prominently displayed detailing how staff could provide feedback. There were formal mechanisms by which feedback from all staff groups could be shared with the managers of the service.

The service actively promoted equality and diversity. It identified and addressed the causes of any workforce inequality. Staff had received equality and diversity training. Staff felt they were treated equally. The service had a diverse workforce, and had made a number of adjustments to support staff groups, for example by adding a prayer room to the premises.

Staff were clear on their roles and accountabilities including in respect of safeguarding and infection prevention and control. Leaders detailed and demonstrated that they had established proper policies, procedures and activities to ensure safety and assured themselves that they were operating as intended.

Structures, processes and systems to support good governance and management were clearly set out, understood and effective. The governance and management of partnerships, joint working arrangements and shared services promoted interactive and co-ordinated person-centred care.

The service undertook staff surveys to review the quality of care provided. Although the service did not question patients directly about partnerships and communities, the majority of patients were satisfied with the service. As the service is telephony-based, CQC did not speak to any patients on the days of the inspection.

Leaders at the service told us that they engaged with services to whom them referred regularly for feedback on the quality of referrals. The leaders told us that a full and diverse range of patients', staff and external partners' views and concerns were encouraged, heard and acted on to shape services and culture.

The commissioners of the service told us that they were satisfied with the way in which the service collaborated with partner organisations.

The service had formalised engagement mechanisms with both their commissioners, and partner organisations in the area.

There was a focus on continuous learning and improvement at all levels within the service. Staff knew about improvement methods and had the skills to use them. The service made use of internal and external reviews of incidents and complaints. Learning was shared and used to make improvements. Leaders and managers encouraged staff to take time out to review individual and team objectives, processes and performance.