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The Surgery - Dr Mangwana and Partners Requires improvement Also known as Palace Surgery

Inspection Summary

Overall summary & rating

Requires improvement

Updated 3 March 2021

We carried out an announced comprehensive inspection at The Surgery- Dr Mangwana and Partners on 18 December 2020 as part of our inspection programme. In response to Covid- 19 we undertook a remote records review on 10 December 2020 prior to the site visit.

At our last inspection in August 2019 we rated the practice as inadequate overall. We served the practice with Warning Notices. We undertook a further inspection in December 2019 to check they had complied with the requirements of the notices.

At that inspection we found that some improvements had been made in most areas. However, they had not met the improvements with regards to monitoring of high-risk medicines, infection prevention and control and having a failsafe system for cervical screening and two week wait referrals. We served the practice with further requirement notices during that inspection.

At this inspection, we found that the practice had satisfactorily addressed the requirements of the notices from the December 2019 inspection. However, there still some work in progress that was being undertaken to ensure that the system for monitoring high risk medicines was complete. All work in progress had been risk assessed with the most urgent work having been satisfactorily completed. The practice had also had a recent change of leadership with the outgoing lead GP currently handing over to the new partner.

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 are mindful of the impact of COVID-19 pandemic on our regulatory function. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have rated this practice as requires improvement overall with the following key ratings:

Safe- Requires Improvement

Effective- Requires Improvement

Caring- Good

Responsive- Good

Well – Led- Requires Improvement

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Although, the practice had satisfactory addressed most safety concerns from the last inspection and implemented new systems and processes there was still some further work necessary and in progress relating to high risk medicines monitoring and responding to historic safety alerts.
  • Patients received effective care and treatment that met their needs. However, the practices patient quality outcomes related to Families, children and young people and Working age people were low and had further reduced since our last inspection.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The practice had new leadership and the way the practice was led and managed promoted the delivery of person-centre care. However, the practice leadership had recently transitioned and required some degree of stability.

The areas where the provider must make improvements are:

•Improve and increase the uptake for childhood immunisations and cervical cancer screening.

The areas where the provider should make improvements are:

  • Maintain work in progress relating to the monitoring of patients on high risk medicines.
  • Maintain systems for monitoring safety alerts and two-week referrals.
  • Continue the process of recruiting a female nurse to support patients who may wish to seek help from a female nurse.
  • Continue to address patient feedback from the National GP Patient Survey.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

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

Inspection areas


Requires improvement


Requires improvement






Requires improvement
Checks on specific services

People with long term conditions


Families, children and young people

Requires improvement

Older people


Working age people (including those recently retired and students)

Requires improvement

People experiencing poor mental health (including people with dementia)


People whose circumstances may make them vulnerable