Newtown Medical Practice

We carried out an announced inspection at Newtown Medical Practice on 14 September 2022. Overall, the practice is rated as Requires Improvement.

Safe – Requires Improvement

Effective - Requires Improvement

Caring - Good

Responsive - Good

Well-led – Requires Improvement

Following our previous inspection on 14 January 2016 the practice was rated Good overall and for all key questions:

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

Why we carried out this inspection

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

How we carried out the inspection/review

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.

This 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 short site visit

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 and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Requires Improvement overall

We rated the practice as Requires Improvement for providing safe, effective and well-led services because:

• Safeguarding alerts were not consistently recorded on the patient record.
• The clinical record, when a high risk medication review or a review of patients with a long-term condition had taken place, was not always fully documented.
• There were limited processes for acting on safety alerts, in particular historic alerts, to minimise the risk if any patients not receiving the monitoring required for the medicines they are prescribed. This was highlighted through the clinical searches we undertook.
• The was a lack of effective governance systems, the practice could not demonstrate effective leadership and there were not clear and effective systems for managing risks, issues and performance.
• The practice did not have a formal audit plan in place.

We rated the practice good for providing caring and responsive services:

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.

We found two breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

In addition the provider should:

• The practice should undertake it’s own inhouse patient survey/patient feedback exercises.
• Work towards improving levels of cervical screening.
• Introduce regular governance and clinical meetings and ensure they are minuted.

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 Hospitals and Interim Chief Inspector of Primary Medical Services