Newport Pagnell 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

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

The future direction of the practice was underpinned by a comprehensive strategy document and we saw evidence that this was being implemented. The annual staff conference was used to shape the future of the practice. New and proactive steps were taken to work with partners and communities. The practice had an exceptional approach to learning, improvement and innovation.

At our previous inspection, we rated the practice as outstanding for providing well-led services. At this inspection, this was changed to good.

This service scored 82 (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.

We reviewed a comprehensive strategy document which advocated strong neighbourhood partnership working, investing in people and redefining measures of success to enable sustainable, high-quality person-centred care. Enhancing patient access was identified as a priority area, with benchmarks for success in the process of being agreed. During our inspection, we saw clear evidence of implementation of the strategy, through close review of access data and proactive steps to respond to changes in surges in demand. The work with GPIP was important in driving the improvement in access and this had been embedded through ongoing review of access data and changes in delivery when these were needed.

Staff described the practice as inclusive, supportive and deeply committed to patient-centred care. A small group reported low morale, which was linked to high workloads and staff turnover. Following the inspection, the provider sent evidence showing the actions they had taken in response to staff concerns. This included conducting an additional staff survey to gain further insight and identify appropriate actions. They also implemented a communication plan, as well as introducing additional initiatives to improve workloads and staff morale.

Workforce resilience was identified as a key area of improvement in the strategy, which included measures to drive staff recruitment and retention. This was underpinned by quantitative goals to measure performance. During our inspection, we saw that the strategy was being implemented as the practice recruited staff and filled gaps.

The practice developed their strategy through discussions with partners, staff and feedback from patients. However, whilst a majority of staff saw a clear direction for the future, a small group of staff remained unaware of the practice’s long-term plans or felt that communication regarding these goals could be improved.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. 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. We saw the leadership team worked with closely with the ICB, voluntary sector and broader community to deliver services which met the needs of the practice population.

The management team maintained oversight through a weekly briefing system and a visible rota that clearly identified which leaders were responsible for each site at any given time. This team was visible, approachable and supportive. Staff highlighted an open-door policy and noted that team leaders were readily available for face-to-face discussions, telephone queries or formal meetings. Staff provided specific examples of leaders being on hand to support with clinical queries or assisting reception staff with difficult patient interactions.

We saw evidence of effective, structured support mechanisms for staff. This included annual appraisals, regular departmental meetings held during protected learning time, and bi-weekly check-ins to discuss staff needs. Staff felt that their managers actively listened to concerns and worked collaboratively to find solutions. This approachable leadership style was described by several staff members as a key factor in ensuring they felt supported in their day-to-day roles.

The practice utilised multiple communication channels including an internal portal, email and meetings. A small number of staff reported that on occasions, senior managers were less available due to the frequency of meetings. Some staff felt that changes were occasionally communicated at the last minute or that information cascades relied too heavily on word-of-mouth.

Staff and leaders spoke positively about the annual NPMC staff conference that was held in March 2025. This was an opportunity to hear ideas for improvement and reflect on the previous year. Strategy documents evidenced that the results of the 2026 staff survey would be used to shape the next conference.

The practice had established Freedom to Speak up arrangements with other practices. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.

Staff praised leaders for being approachable and for promoting an open, transparent, and non-punitive atmosphere. Staff at all levels felt that they could raise concerns or suggest improvements.

The service valued diversity in their workforce. They worked 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. There were effective information cascades across the 3 sites to make sure that staff were included in updates. Each member of staff would work across all branches in accordance with rotas to ensure there was a unified approach.

The Equality, Diversity and Inclusion Working Group included both staff and patients. To reinforce a zero‑tolerance culture, staff were supported to share their experiences of abuse alongside zero‑tolerance posters to help highlight the impact of unacceptable behaviour. We saw evidence that workforce inclusion was actively prioritised, through the annual practice conference and measures to support relevant staff with their mental health and through life events such as menopause.

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

Monthly clinical meetings were held alongside specialist matrix MDT meetings, including cancer, safeguarding and prescribing. Quarterly partner away days were used to identify learning and development requirements, which informed subsequent training plans.

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 service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The practice worked with local voluntary organisations, including the Brooklands Centre, to support people living with dementia and their carers. They had partnered with the local gym to deliver a young people’s mental health programme.

The practice also supported refugees temporarily housed in a local hotel on multiple occasions. They collaborated with refugee charities, the city council and community leaders to provide on‑site outreach services. These included health‑promotion activities with interpreter support, organising English classes arranged through the council and a dedicated clinic to assess the migrant group for latent tuberculosis.

The practice had been invited by the ICB and the Integrated Neighbourhood team to identify hidden or unrecognised carers to access support. Tailored SMS messages were sent to carers to prompt self-identification and subsequent activity was monitored.

During our inspection, we spoke with representatives from local care homes. They told us that the practice took all opportunities to involve them in local pilots and multi-disciplinary meetings aimed to improve care. One pilot involved securely sharing digital patient information, which has since been adopted more widely across the locality.

The practice gave examples of services that they provided to patients outside of the practice to support the wider community, such as the carers’ café and urology services. These had a positive impact on the health and wellbeing of those in the locality.

The practice were early adopters of neighbourhood working in line with the national 10 Year Plan, and in their strategy, the practice advocated continued advancement of their partnerships with local authorities, voluntary organisations and community groups.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

In their strategy, the practice had committed to embed quality improvement into daily practice, involving staff, patients and the PPG. This built on a quality improvement masterclass that had been delivered the previous year.

The practice is a training practice, and a recent away day for partners resulted in an agreement for all partners to complete educational training to become clinical or educational supervisors for GP trainees to expand the current provision. Time had been and continued to be allocated to undertake this training. In addition to this, the practice had recently added another training program which supported students for Primary Care Block and Elderly Chronic Care Block students. These students act as part of a multidisciplinary team, focusing on continuity of care, and the long-term management of chronic conditions.

The practice has also supported training placements for student Pharmacists, Student Paramedics, Student Occupational Therapists, Student Nurses and Student Physician Associates with the long-term vision to become a training practice for as many professional disciplines as possible.

There was an innovative approach to supporting patients with mental health needs. This work was led by a GP partner, who collaborated with ShinyMind, a mental health and wellbeing app co‑designed with the NHS. The app provides patients a library of tools, exercises, activities, and wellbeing resources intended to help patients with poor mental health. To date, 569 patients were actively using their prescription.

Evaluation of the programme indicated several benefits, including reduced GP workload, increased access for large patient cohorts (100+ patients at a time), improved team wellbeing and an overall reduction in patient demand. Building on this, the GP partner continued to work with ShinyMind to expand and test the model further, leading the development and delivery of a 4‑week virtual mental health programme. At the time of our assessment, four group consultation sessions had been delivered.