The Care Quality Commission
  • Doctor
  • GP practice

Wellington Medical Practice

Overall: Requires improvement read more about inspection ratings

The Health Centre, Victoria Avenue, Wellington, Telford, Shropshire, TF1 1PZ (01952) 226000

Provided and run by:
Wellington Medical Practice

All Inspections

11 October 2023

During a routine inspection

We carried out an announced inspection at Wellington Medical Practice on 11 October 2023. Overall, the practice is rated as Requires Improvement. We rated the key questions:

Safe: Requires Improvement

Effective: Requires Improvement

Caring: Requires Improvement

Responsive: Inadequate

Well-led: Requires Improvement

Following our previous inspection on 20 August 2018, the practice was rated as good overall. It was rated as good for providing safe, effective, caring and well-led services and requires improvement for providing responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Wellington Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out a comprehensive inspection because the last rating was awarded more than five years ago. We also inspected so we could follow up on improvements made as a result of the previous inspection, and in response to feedback/intelligence we had received about the service.

Our focus included:

  • Safe, effective, caring, responsive and well led key questions.
  • A follow up on the advisory actions identified in our previous inspection.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing and in person on site.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A site visit.
  • Staff questionnaires.
  • Feedback from external stakeholders.
  • An interview with a representative of the patient participation group (PPG)

Our findings

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
  • information from the provider, patients and other organisations.

We found:

  • Safeguarding systems were in place and staff demonstrated a clear understanding of the reporting and recording processes.
  • Areas of the practice we observed were clean and hygienic.
  • Staff recruitment checks had not been carried out in accordance with regulations.
  • The system for recording and acting on safety alerts was not always effective.
  • Health and safety risk assessments had been carried out and actions taken to mitigate identified safety risks for patients and staff.
  • Patients with a potential missed diagnosis of diabetes had not received care in line with best practice guidance.
  • Most staff were up to date with essential training requirements and were provided with good opportunities for learning and development to expand their role of professional practice.
  • The practice had a limited programme of quality improvement.
  • The management of patients with a long-term condition was not always effective.
  • Patients were not always treated with kindness, respect and compassion.
  • Results of the national GP patient survey were lower than local and national averages with 3 of the 4 indicators being either a negative variation or tending towards a negative variation for providing caring services. Patient satisfaction for the previous 5 years was consistently below local and national averages.
  • The practice had a designated staff champion for carers and had identified 769 patients registered as carers, 5% of the practice population.
  • All 4 indicators from the national GP patient 2023 survey for the practice were significantly lower than local and national averages for accessing the service.
  • Staff felt supported in their work and found leaders approachable, supportive and visible.
  • Structures, processes, and systems to support good governance were in place but not fully embedded into practice.

We found a breach of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed

The provider should:

  • Evaluate the National GP patient survey results for the practice and implement an improvement strategy to improve patient experiences.
  • Implement measures to actively and effectively engage with the patient participation group.
  • Take action to improve the number and quality of medicine reviews.
  • Take steps to improve patient privacy and dignity at the reception desk.
  • Implement a programme of targeted quality improvement.
  • Review the responsibilities of the role of the practice co-ordinator/patient engagement lead.
  • Take action to improve childhood immunisations uptake for 5 year olds to meet minimum target.
  • Take steps to obtain records of staff immunisations for those staff with direct patient contact, including reception staff.
  • Take action to evaluate and improve the effectiveness of how patients are reviewed and supported in care homes by the practice.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Healthcare

20 August 2018

During a routine inspection

This practice is rated as Good overall.

We previously carried out an announced comprehensive inspection at Wellington Medical Practice in July 2017 and rated the practice as good overall but with requires improvement for responsive services. A breach of legal requirements was found and a requirement notice was served in relation to good governance. We found that the practice had not responded to patient feedback that highlighted significant problems when trying to contact the practice by telephone. The appointment system and the number of appointments available did not meet patient needs. The full comprehensive report on the July 2017 inspection can be found by selecting the ‘all reports’ link for Wellington Medical Practice on our website at .

We carried out an announced comprehensive inspection at Wellington Medical Practice on the 20 August 2018 to confirm that the practice had met the legal requirements in relation to the breach in regulation that we previously identified in July 2017.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? –Requires Improvement

Are services well-led? - Good

At this inspection we found:

  • The practice had systems, processes and practices in place to protect people from potential abuse. Staff were aware of how to raise a safeguarding concern and had access to internal leads and contacts for external safeguarding agencies.
  • The practice had systems to manage most risks so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • There were systems in place for identifying, assessing and mitigating most risks to the health and safety of patients and staff. However, the system for monitoring of patients on high risk medicines was not effective.
  • Staff recruitment practices were in line with legal requirements.
  • The practice had reviewed the appointment system in response to patient feedback. This had resulted in a move from telephone triage to face to face appointments. The clinical team had expanded to include a variety of allied health professionals so that more face to face appointments could be offered. However, further work was needed to improve patient satisfaction in relation to access to appointments.
  • The practice had installed a new telephone system to better manage patient calls.
  • Formal recorded clinical supervision had been introduced.
  • The practice had an active patient participation group.
  • The practice had identified a significantly increased number of patients who were carers and had introduced a patient engagement lead to improve communication with patients.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

  • Review the system for monitoring of patients on high risk medicines.
  • Introduce a system which ensures staff have read, understood and implemented practice policies.
  • Further respond to patient feedback to improve their satisfaction with the appointment system.
  • Further review reception staffing levels and the deployment of reception staff during busy periods.
  • Ensure information about how to make a complaint is easily available for people to access.
  • Review the practice complaints to identify trends.
  • Expand the practice’s action plan for responding to the results of the GP patient survey to include actions to address the lower than average results around consultations with health care practitioners. In particular, the feedback relating to how well healthcare practitioners listened to them.

Professor Steve Field CBE FRCP FFPH FRCGP Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

31 July 2017

During a routine inspection

Letter from the Chief Inspector of General Practice


We previously carried out an announced comprehensive inspection at Wellington Medical Practice on 8 December 2015. The overall rating for the practice was Requires Improvement, with the Safe and Well Led key questions being rated as Requires Improvement. The practice was rated as good for the key questions of Effective, Caring and Responsive. We found two breaches of the legal requirements and as a result we issued a requirement notice in relation to:

  • Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Good Governance.
  • Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 – Fit and Proper Persons Employed.

The full comprehensive report from the inspection on the 8 December 2015 can be found by selecting the ‘all reports’ link for Wellington Medical Practice on our website at www.cqc.org.uk.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and improvements had been made to the system in place for reporting and recording significant events.
  • The practice had some systems to minimise risks to patient safety.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Information about services and how to complain was available.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

There were two recurrent themes throughout the inspection when reviewing information held and speaking with staff and patients

  • Patients and staff commented that there was an apparent shortage of appointments.
  • Patients said they experienced difficulty when trying to contact the practice by telephone and expressed dissatisfaction with the appointment system.

Importantly the provider must:

Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. In particular:

  • The practice must respond to patient feedback that highlighted significant problems when trying to contact the practice by telephone.
  • Ensure that the appointment system and the number of appointments available meets patient needs

Additionally there were areas of practice where the provider should make improvements.

The provider should:

  • Review the system for managing alerts to monitor that agreed actions have been completed.
  • Formalise and record clinical supervision which takes place between the nurse practitioner and GP.
  • Implement a programme of quality improvement.
  • Ensure patients records are updated when a repeat prescription for medication is stopped. Implement a formal system to monitor that clinical guidelines are followed.
  • Ensure staff are up to date with their required training and have awareness of the named safeguarding lead within the practice. Document informal as well as formal complaints.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

08 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wellington Medical Practice on 8 December 2015. Overall the practice is rated as requires improvement.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Our key findings were as follows:

  • Staff knew how to and understood the need to raise concerns and report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and acted upon.
  • Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks and the lack a comprehensive business continuity plan.
  • Best practice guidance was used to assess patients’ needs and plan and deliver their care.
  • The majority of patients spoken with said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice operated a GP triage system for appointments. All patients were offered a telephone consultation and appointments were made as required, often on the same day. Patients had mixed views about the appointment system, and several patients commented that it could be difficult to contact the practice by telephone when the practice opened in the morning.
  • Information about services and how to complain was easy to understand but not readily available as patients had to ask for the practice leaflet.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice had a number of policies and procedures to govern activity, but some of these were not dated or include a review date.
  • There was a clear leadership structure and staff felt supported by management.
  • The practice did not proactively seek feedback from patients and did not have a patient participation group, although there were plans to develop this in the near future.

We saw several areas of outstanding practice including:

  • The practice had introduced a process to follow up on children under the age of 16 years who did not attend hospital appointments. The practice contacted the parent/guardian by telephone or letter to invite them to an appointment to discuss the reason for nonattendance. Those families who did not respond were referred to the health visitor or school nurse to follow up.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

  • Ensure that all necessary pre-employment checks are obtained and appropriate evidence kept on file.

  • Ensure there are systems in place to assess, monitor and improve the quality and safety of the service.

In addition the provider should:

  • Carry out periodic fire drills to ensure staff know how to follow the fire evacuation procedure.
  • Introduce a system to check that any abnormal results are discussed with patients and appropriate action taken.
  • Ensure that staff appraisals are up to date and carried out annually.
  • Make information about how to make a complaint easily accessible to patients and introduce a system to record verbal/informal complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

9 July 2013

During a routine inspection

Patients had mixed views about the service they received at the practice. Everyone we spoke with was satisfied with the way they were treated by reception staff while in the surgery. One person told us, 'They are very friendly'. Most patients said they felt they were listened to and respected by medical staff.

The overwhelming majority of patients we spoke with were dissatisfied with the practice's recently introduced appointment booking system. The staff told us that they preferred the new system and that it increased the amount of contact between doctors and their patients.

We found that patients received their treatment in a clean, hygienic environment. The practice had suitable arrangements in place to ensure patients were not placed at risk of cross infection.

There were suitable numbers of staff with appropriate qualifications working at the practice. The practice had contingency plans in place to deal with any unexpected staff shortages.

We also found that the practice had appropriate internal audit systems in place to monitor and improve the quality of the service it provided.

The practice had a clear and comprehensive complaints policy. We saw that the practice dealt with complaints it received in a timely and appropriate way.