Newnham Walk Surgery

We carried out an announced, focused inspection of this service on 27 January 2020. This was to follow up on the breach of regulation identified at our previous inspection on 31 January 2019.

At the previous inspection, we rated the practice as good overall, with requires improvement for providing safe services and for providing effective services to the population group working age people (including those recently retired and students). At this inspection, we reviewed these areas and found the provider had made improvements. The comprehensive report on the 31 January 2019 inspection can be found by selecting the ‘all reports’ link for Newnham Walk Surgery on our website at www.cqc.org.uk.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

We have rated this practice as good for providing safe services and continues to be rated good overall.

At this inspection we found:

• Improvements had been made to processes in the management of high risk medicines, and we saw that the practice had oversight of high-risk medicine monitoring prior to prescribing.
• The prescribing of antibiotics was in line with the clinical commissioning group and England averages.
• The practice had completed an infection prevention and control audit. Some actions had been completed and a plan was in place which identified priorities for the remaining actions to be completed.
• The practice’s process for managing patient safety alerts had been reviewed, had improved and the new process had been embedded.
• The practice had worked to improve their oversight of the uptake of cervical screening for eligible patients aged 25 to 64 years. Work continued to identify patients who may have moved from the area and deduct them from the practice list, if appropriate, and patients who had opted to have cervical screening performed elsewhere were recorded on the patients record.
• The practice had reviewed their coding of carers to ensure it was accurate. Searches and audits had been undertaken to support the identification of carers. These focused on key patient groups, for example, patients vulnerable to admission to hospital, those who need a home visit and those with mental health needs.
• The practice had increased awareness of the patient participation group (PPG) though prescription notice invitations as well as advertising in the waiting rooms, on compliment slips and through the practice website.

The area where the practice should make improvements:

• Continue to review and improve the uptake of cervical screening.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BS BM BMedSci MRCGPChief Inspector of General Practice

This practice is rated as Good overall. At the previous inspection in October 2015 the practice were rated as good overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Newnham Walk Surgery on 31 January 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We concluded that:

• Patients were able to access care and treatment in a timely way and the practice achieved higher performance than both the CCG and England average for access through the GP National Patient Survey.
• Quality Outcomes Framework data was generally in line with, or above, local and national averages. Exception reporting data was generally lower than both the CCG and England averages.
• Data from Public Health England showed the practice performance for cancer screening was mixed; for breast and bowel screening the practice was in line with CCG and national average but for cervical screening uptake was lower than the CCG and England averages.
• Staff we spoke with were positive about working at the practice and the leadership and management team.
• The practice had a number of links and regular contact with a variety of support groups and services such as eating disorder clinics, university medical services and Improving Access to Psychological Therapies.
• The practice employed a GP Psychotherapist who held two morning clinics at the practice each week.
• The practice assessed and responded to the needs of their population groups.
• Patients with spoke with were positive about the practice, the services offered and the care and treatment delivered at the practice.
• The practice’s performance in the GP National Patient Survey was higher than CCG and England averages.

However, we also found that:

• Some legal requirements were not met.
• The practice’s process for managing patient safety alerts was not always effective.
• The practice did not have complete oversight of all high-risk medicine monitoring prior to prescribing.
• The practice’s prescribing of co-amoxiclav, cephalosporins and quinolones was higher than the CCG and England averages.
• The practice had only identified approximately 0.2% of their practice patient list as carers, following out inspection; following our inspection, the practice reviewed their carers register and found they could identify approximately 0.7% of their patients as carers.
• The practice did not have an active patient participation group, there was a group of patients who were in contact by email, but this was not regular.

We rated the practice as requires improvement for providing safe services because:

• The practice’s process for managing patient safety alerts was not always effective.
• The practice did not have complete oversight of all high-risk medicine monitoring prior to prescribing.

The practice was rated as good for providing effective services overall and to all population groups apart from working aged people which was rated as requires improvement for providing effective services.

The practice was rated as requires improvement for providing effective services to working aged people because:

• The practice’s uptake of cervical screening was lower than both the CCG and England averages and significantly lower than the 80% national target rate set by Public Health England. Following our inspection, the practice took some action to try and improve uptake.

We rated the practice as good for providing caring, responsive and well-led services.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Continue to identify ways to encourage and improve the number of eligible patients attending for cervical screening.
• Review the carers register to ensure it is accurate and appropriate for the practice population.
• Continue to develop and encourage patient participation at the practice.
• Continue to monitor the prescribing levels of co-amoxiclav, cephalosporins and quinolones.
• Complete actions identified in the recent infection prevention and control audit.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice