Towcester Medical Centre

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed all the quality statements from this key question. The practice had systems to assess, monitor and continue to improve the quality and safety of service. There were processes for monitoring patients’ health in relation to the use of medicines including medicines that require regular reviews. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the patient participation group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. Staff felt there was an open culture. Staff were provided with access to a Freedom to Speak Up Guardian. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. The leadership team reviewed complaints and learning events annually to see if there were trends that needed further action or investigation. Learning from incidents and complaints resulted in changes that improved care for others.

However, we found that not all systems were adopted and operating effectively in the dispensary. We found that not all significant events were following practice reporting processes and that the process for recording near misses was not consistently applied. Leaders took prompt action to respond to feedback, developing and implementing new, strengthened processes to reduce identified risks and ensure dispensary staff were following practice protocols.

Leaders and staff worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. Referrals and test results were managed in a timely way and followed up promptly when required.

The practice worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. There was an experienced, engaged and capable safeguarding lead supported by a safeguarding administrative lead. Safeguarding policies were in place, comprehensive, up-to-date and regularly reviewed. All staff understood their responsibilities around safeguarding and were appropriately trained in safeguarding procedures. A random sample of staff files we reviewed showed all staff had suitable Disclosure and Barring Service (DBS) checks based on the role and responsibilities of the job and had completed adult and child safeguarding training at the recommended level, with refresher training at the appropriate frequency. (The DBS checks whether a prospective employee has a criminal record or has been barred from working with children or vulnerable adults, depending on the level of check carried out). The practice maintained a list of vulnerable people and acted on concerns working in partnership with other organisations. Regular safeguarding meetings were held with the local multidisciplinary team such as health visitors. Staff were aware of safeguarding issues specific to their practice population. Appropriate clinical coding was used to flag people on the safeguarding register and their family members.

Staff worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs which was safe, supportive and enabled people to do the things which mattered to them. Emergency equipment was available and maintained. In the 2025 national GP patient survey, 91% of people who responded said they were involved as much as they wanted to be in decisions about their care and treatment. This was in line with the national average. Staff could recognise a deteriorating patient and knew of action to take. They had instant access to the doctor on call each day, who sat in the reception area. Patients were advised on risks related to their condition and actions to take if their condition deteriorated.

The practice detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

There was a business continuity plan in place which was monitored and reviewed. Contracts were in place to ensure the premises were maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. We observed fire exits were clear and fire safety equipment was easily available and regularly checked. Staff were aware of what to do in an emergency and where emergency medicines and equipment were stored. Allocated staff also knew how to safely manage spillages of bodily fluids. We observed that the clinical rooms and offices used by the GP practice were fit for use and there were room checks undertaken. All equipment had been checked and calibrated as required. We identified there was no security mechanism on the dispensary door, the practice took immediate action to install a lock during our assessment.

Leaders made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked collaboratively to provide safe care that met people’s individual needs. The practice employed non-medical prescribers and had established formal processes in place to monitor and audit their clinical practice. This formal process included annual audits of their prescribing practice, regular appraisals, feedback and support. A sample of staff files we reviewed showed that all staff were suitably qualified, maintained their professional registrations and their continuing professional development (CPD) and had up-to-date specialist training appropriate to their role. All staff had appraisals, access to regular clinical supervision and protected time to complete their mandatory training. We reviewed evidence that demonstrated safe recruitment practices were followed. In the 2025 national GP patient survey, 96% of people who responded said they had trust and confidence in their healthcare professional, this was above the national average of 92%.

The practice had developed systems to assess and manage the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Leaders ensured that facilities and equipment were safe, and that equipment was maintained according to manufacturers’ instructions. The practice had a designated infection, prevention and control (IPC) lead and all staff had completed relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

The practice was able to demonstrate that it had an employee immunisation programme. Records of staff immunisation status were maintained. All staff received an occupational health assessment which included a review of their immunisation needs.

The practice made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines.

We reviewed the process for managing prescription stationery and identified improvements that could be made to reduce risks. The practice took immediate action to the feedback received and made changes during our assessment to improve safety.

Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. During our assessment, we found gaps in the paper records for checking fridge temperatures at the dispensary. However, these fridges had internal dataloggers which accurately tracked and recorded the temperatures of fridges throughout the day. Although, this mitigated the risks, evidence reviewed suggested the datalogger logs were not checked daily to ensure temperatures remained within safe limitations. We discussed this with leaders who advised they would be establishing better systems to ensure records were maintained in line with protocol. Immediately after our assessment, the practice submitted evidence of an improved standard operating procedure for fridge checks at the dispensary. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines and vaccines. However, we found one item had expired in November 2025 and there was no robust date checking schedule in place in the dispensary. The practice team took swift action to replace the item and to update their protocols to improve oversight of short-dated medicines and reduce the risk of recurrence.

Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. The provider had effective systems to manage and respond to safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. For example, we reviewed patients prescribed a specific teratogenic medicine. Teratogenic medicines are medicines that can cause birth defects and therefore women of childbearing age should be informed of the risks and be on effective contraception, whilst also receiving regular reviews. Our searches identified 28 women of childbearing age taking one specific medicine and we reviewed records for 5 of these patients and found evidence the practice was reviewing and recalling these patients. One patient didn’t appear to have a signed form saved in the record and the practice took action to rectify this immediately following our assessment.

There were suitable processes for staff to follow when dispensing medicines, although we identified some gaps. For example, we found that whilst staff advised 2 checks were undertaken when issuing controlled drugs, we found there were no logs kept of the secondary check. Leaders took immediate action to improve the process for the secondary checking before medicines were issued and ensure records were kept accordingly. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. Prescribing data reviewed as part of our assessment confirmed this. For example, the number of antimicrobials issued by the provider was in line with local and national averages. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.