Newport Medical Group

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

At our last assessment, we rated this key question as good. At this assessment, the rating has changed to requires improvement.

This service scored 61 (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.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. 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 was approachable and responded to any concerns raised. Staff also told us leaders modelled the values of the practice.

However, the circumcision clinic did not have robust leadership that had enough knowledge about how to manage the service safely. They did not recognise the need to ensure that children should be weighed or that people who worked in the service should have robust training and supervision.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had established Freedom to Speak up arrangements. Staff were aware of how to raise concerns. We saw that staff meetings were taking place on a monthly basis, with staff able to discuss concerns, both professional and personal either in a group setting or one to one with the management team. We were told that informal discussions about cases occurred regularly, where staff asked for advice and guidance from senior colleagues.

The service strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. We saw senior leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support staff who had caring responsibilities.

The provider did not always have clear responsibilities, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes

Governance systems were not effective in identifying or managing key risks. The service had no safe processes to mitigate the risk of data breaches, and intimate images of circumcision procedures were being sent by parents directly to the lead doctor’s mobile phone.

There were no effective arrangements to ensure staff working in the circumcision clinic were appropriately trained, supervised, or assessed as competent. A receptionist was undertaking post‑procedure bleeding checks without formal competency sign‑off from a suitably qualified clinician.

The service also lacked policies to ensure babies were weighed prior to circumcision, creating a risk of incorrect local anaesthetic dosing. These gaps demonstrated ineffective oversight and a failure to ensure safe clinical practice. Following the inspection, the provider submitted an action plan outlining changes to their systems which mitigated the risks identified during the inspection. The plan included a new policy for circumcisions, which highlighted clinical supervision for all aspects of the procedure (e.g,bleed checks, pre‑procedure weighing). The plan also introduced the use of an NHS‑approved electronic system for securely storing any photographs shared by parents or carers.

However, 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, however the governance of the circumcision service was not robust. 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 understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The provider worked with partner organisations to deliver the flu and covid vaccination programmes. Staff had coordinatedcare with community healthcare services, including utilising clinical pharmacists employed by the practice to increase take-up of vaccines such as flu and covid.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. We found there some gaps in learning and improvement for the circumcision service such as lack of peer reviews and external auditing which did not allow for continuous learning and improvement.