Leadership structure

The RCGP Primary Care Development Team assisted a practice in developing a new leadership structure and negotiating a move to new purpose-built premises, ultimately improving their CQC rating.

RCGP Primary Care DevelopmentThe issue

After a CQC inspection, a practice was found to have deep issues in their leadership structure. The RCGP Primary Care Development Team undertook a scoping exercise to diagnose the problems faced by the practice.

We discovered that along with a clear lack of leadership at the practice:

  • The GP who was the driving force for engaging with RCGP support thought they were one of five partners, but they were in fact salaried. This meant there were actually four partners, some of whom nobody at the practice had ever met. 
  • The senior partner was considering retiring.
  • The practice manager was also functioning as head receptionist.
  • There were issues moving from their outdated and unfit premises due to the lack of financial investment of some of the partners.

Two months into providing support, the RCGP was informed that the salaried GP who had been the main contact for the support had left the practice. The remaining partners were unengaged with the support process and a re-inspection of the practice saw no improvement to their rating and they remained in Special Measures. 

At this point the CCG and NHS England intervened. A new partnership was put in place at the practice, with the salaried GP who had left returning to take the position of senior partner.

How we helped

Upon the senior partner’s return, they re-engaged with our advisory team who provided intensive support to the new leadership team as well as the practice manager and nursing team. We also provided support in negotiating a move to new, purpose-built premises. RCGP support continued until the practice was re-inspected by the CQC.

Outcomes / impact

The result of that inspection was a complete turn-around for the practice which achieved a rating of 'Good' across all areas and an 'Outstanding' rating in the area of leadership.

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