29 September 2021
The Nuffield Practice is located in Witney:
We visited the location only during this inspection.
The provider is registered with CQC to deliver the following Regulated Activities:
- Diagnostic and Screening Procedures
- Maternity and Midwifery Services
- Treatment of Disease, Disorder or Injury
- Surgical Procedures
- Family Planning Services
The practice is part of Oxfordshire Clinical Commissioning Group.
There are 10 GPs working at the practice including the GP Directors for the provider. The practice has a population of approximately 12,000 patients. There are 2.6 whole time equivalent practice nurses two of whom are qualified to prescribe. The nursing team also has health care assistants working with qualified nurses. A clinical pharmacist supports the clinical team. The clinical team is supported by the practice manager and a team of 21 reception and administration staff.
The Nuffield Practice has a purpose built location with good accessibility to all its consultation rooms. The practice serves patients from the surrounding town and villages. The practice demographics show that the population has a higher proportion of patients over 65 compared to the national average and lower prevalence of younger patients. According to national data there is minimal deprivation among the local population. There are patients from minority ethnic backgrounds, but this is a small proportion of the practice population.
The practice is open between 8am and 6.30pm Monday to Friday. Appointments can be booked on the day only and a duty doctor system is used to assess the urgency of patients' needs.
Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If GPs need to see a patient face-to-face, then the patient is offered an appointment onsite. Online consultations are also available.
The practice has opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the practice is closed and these are displayed at the practice, in the practice information leaflet and on the patient website. Occasionally, out of hours services are provided during protected learning time by another provider who also provide out of hours service after 6.30pm, weekends and bank holidays. This service is accessed by calling NHS 111.
29 September 2021
We carried out an announced focused follow up inspection at The Nuffield Practice on 2 September 2021 to identify if improvements had been made following our previous inspection in November 2019. The 2019 inspection led to a rating of requires improvement and found breaches of regulation. We issued the provider with requirement notices in order for the service to make improvements.
This inspection was to provide a new rating to the service and ensure the breaches of regulation had been met.
Safe - Good
Effective - Good
Well-led - Good
The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Nuffield Practice on our website at www.cqc.org.uk
Throughout the pandemic, CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements
The inspection included:
- Conducting staff interviews using video conferencing
- Completing clinical searches on the practice’s patient records system and discussing findings with the provider
- Reviewing patient records to identify issues and clarify actions taken by the provider
- Requesting evidence from the provider
- A site visit at the practice.
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 have rated this practice as good overall and for all population groups.
We found that:
- Safety systems and processes were operated effectively to ensure patients received safe care and treatment.
- Patients’ needs were assessed and their care planned and delivered in line with national guidance.
- Staff were supported and trained to ensure they could access guidance and had the skills and knowledge required to deliver effective and safe care.
- Patients’ rights were protected.
- Patients reported being well supported overall in the feedback we received and reviewed.
- There were systems to consider patients’ views in relation to the delivery and design of the service.
- Governance processes were clear and had improved since the previous inspection in November 2019.
- The monitoring of staff training had improved.
- There was a process for staff to receive role specific inductions.
Whilst we found no breaches of regulations, the provider should:
- Complete the full roll-out of training in female genital mutilation and child sexual exploitation to eligible staff.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care