Newson Clinic

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that patients were protected from abuse and avoidable harm.At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

This service scored 81 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Newson Clinic had an incident reporting and management policy in place to support staff to report incidents, near misses and safety events. The service had a positive culture of safety and leaders encouraged staff to raise concerns when things went wrong. Staff felt there was an open culture, and that safety was a top priority.

Lessons were learnt to continually identify and embed good practice. Learning from incidents and complaints was discussed in meetings and resulted in changes that improved the service. Weekly complaints and incidents meetings were established for staff and regular one-to-one meetings with remote clinicians were scheduled to ensure learning from incidents reached all staff promptly.

Staff provided us with examples of incidents which had been reported and the actions the service had taken in response to the learning identified. One incident we discussed with staff related to an IT system failure which resulted in a patient letter being manually sent out instead of automatically. Staff inadvertently sent the patient letter to the wrong patient, and the service was notified by the recipient patient of the error.

The service investigated the incident and applied the Duty of Candour by contacting both patients involved and apologising for the error. The incident was discussed at the weekly complaints and incidents meeting. The cause of the error was identified as the removal of the safeguard in the IT system which sends patient letters automatically to the correct patient. To prevent this incident from reoccurring, a new Standard Operating Procedure was developed. This instructs staff that in the event of an IT failure, patient letters are not to be sent out manually but to wait for the IT system to be re-instated.

Leaders demonstrated they were passionate about learning and research. There was a ‘Newson Research’ department for women’s health within the service which had produced 20 peer reviewed papers to date that had been published within medical journals such as the ‘British Journal of Psychiatry,’ ‘Menopause,’ ‘Journal of Sexual Medicine,’ and ‘Maturitas.’

In addition to published articles in medical journals, leaders provided free presentations on women’s health to various organisations and events around the world, including the All-Party Parliamentary Group (APPG) on Osteoporosis and Bone Health;Endometriosis Cumbria Support Group; Imperial College Women’s Federation; Canadian Mounted Police; and Netherlands Women’s Health. Between January and October 2025, the service had provided over 17 of these free presentations.

The service worked with patients and healthcare partners to establish and maintain safe systems of care. Staff worked to facilitate continuity of care, including when patients moved between services. With patient consent, the service shared information about their treatment appropriately with the relevant healthcare partners such as the patient’s NHS GP. This meant patients experienced a joined-up approach to the management of their care and treatment. Leaders told us they had received positive feedback from NHS GPs they had engaged with who had expressed appreciation for the contact and information they had received from the service regarding shared patients, and this engagement had supported their learning.

The service had a clear onward referral pathway for both private healthcare providers and the NHS. We discussed the process for urgent referrals and staff explained they liaised with medical consultants across the UK for patients and facilitated 2 Week Wait referrals (urgent suspected cancer referrals) with NHS GPs. Our review of patient records showed referrals were managed appropriately and in a timely manner.

Safeguarding policies and procedures were in place to keep people safe and safeguarded from abuse. The service had thoroughly reviewed their patient demographic when developing the safeguarding policy. As such, the service had a robust domestic abuse process and there were resources and information within the policy detailing Female Genital Mutilation (FGM) and sexual abuse support.

The service had two safeguarding leads who had completed advanced safeguarding training Level 4. All staff had completed the relevant safeguarding training for their role and shared concerns quickly and appropriately. The service maintained a patient safeguarding register and alerts were used on the clinical IT system to identify patients who were at risk of harm or abuse. A safeguarding meeting was held regularly every two months to discuss safeguarding risks and review the safeguarding register. Interim safeguarding updates were also provided for staff as required.

The service worked in partnership with other organisations to act on safeguarding concerns. Staff gave us an example of a patient who had disclosed to a clinician that they were experiencing financial abuse. The service offered to speak to the police on the patient’s behalf and contacted their NHS GP to alert them of the safeguarding concern identified. The NHS GP followed up with the patient at an appointment scheduled the same day. The partnership of Newson Clinic and NHS GP provider led to a positive outcome for the patient who expressed their thanks for the support they received.

Staff understood the risks and potential side effects of the treatments they offered. The service ensured all patients completed a pre-appointment questionnaire and discussed this during their consultation so that every aspect of risk could be explored. In addition to risks being discussed as part of the consultation, after their appointment patients were provided with written summaries of their consultation and information on the risks of treatment.

In addition to the services provided for patients through the clinic, patients were able to access the ‘Balance’ software application programme which provides medically approved resources to educate and enable patients to make informed choices about their care and treatment.

Staff followed internal service policies and operating procedures when assessing and treating patients. Our patient records review as part of this assessment found consultation notes were detailed and we saw evidence of risks and side effects being communicated to patients.

As part of our assessment, we received patient feedback about the service. The vast majority of patients reported positive experiences of using the service and told us clinicians had fully explained their treatment including risks and side effects.

The service detected and controlled potential risks. They made sure equipment, facilities and technology supported the delivery of safe care. Contracts were in place to ensure the premises were maintained. Systems were in place for the checks of fire alarms, fire extinguishers and fire evacuation procedures. Portable Appliance Testing (PAT) was completed annually to ensure equipment was safe to use. The service provided us with evidence of health and safety risk assessments which showed that risks were properly managed. There was a comprehensive business continuity plan in place which was monitored and reviewed.

Facilities and equipment at both clinics were well-maintained and were suitable for the intended purpose. The clinic facilities were accessible to patients. The Winton House clinic building was step-free for patients, with full access for wheelchair users. Consultation rooms were located on the ground floor. The Wimpole Street clinic building had steps at the entrance, however there was a lift available to access the consultation room.

As part of our assessment, we checked the emergency equipment and medicines available at the clinics and reviewed the processes to maintain these. The service had recently updated their Emergency Medicines policy and had undertaken a risk assessment with an external company. As a result, the service purchased a defibrillator and acquired additional emergency medicines for the Winton House clinic. At the Wimpole Street clinic, the service rented consultation rooms in a modernised building which was used by another private healthcare provider. As such, the service worked alongside them to ensure the safety and upkeep of the premises and emergency equipment. Emergency equipment and medicines were checked regularly, and documented logs were maintained to confirm functionality and expiry dates. All staff had been trained to deal with emergencies including the use of emergency equipment, and basic life support and sepsis training.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.There were a range of clinical and non-clinical roles within the service. We found training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence.

The service had a ‘Newson Education’ department where staff worked to provide healthcare professionals with the latest knowledge, clinical insights and practical tools to enhance their confidence in diagnosing and managing hormone-related conditions.

There was a comprehensive on-boarding programme for new clinical starters at the service. This included clinicians’ completing Newson Clinic’s CPD accredited ‘Confidence in Menopause’ course prior to starting their role. There was an enhanced mentorship programme for all new clinicians which included a structured induction and supervision. Supervisors had scheduled check-ins with new doctors after each clinic to begin with followed by weekly check-ins and 3 monthly. In addition to the check-ins between the new doctors and supervisors, the service undertook patient consultation notes audits for new doctors every 6 weeks, then 3 months, 6 months and 12 months. After a doctor had worked for the service for 12 months, their consultation notes were reviewed on an annual basis to ensure high-quality, safe care for patients.

Ongoing support for clinical staff included a range of meetings. There were monthly clinical meetings where staff shared best practice; engaged in case and research discussions; and reviewed any other relevant updates based on patient demographic. There was a monthly ‘lunch and learn’ meeting with Dr Louise Newson which was open to all clinical staff and provided an opportunity for staff to refresh or enhance their knowledge base. There was also a bi-monthly ‘lunch and learn’ meeting with the Clinical Lead in Winton House which provided support and education for the clinical and non-clinical team. In addition to scheduled meetings, every Monday the service sent out updates to staff where learning and updates on research was shared; any changes within the service were communicated; and any updates on relevant clinical guidance and Central Alerting System (CAS) alerts was provided. CAS is a web-based system for issuing patient safety alerts, important public health messages and other safety critical information and guidance to the NHS and independent providers of health and social care.

Leaders told us that they arranged for external speakers to attend meetings to provide specialist knowledge for staff. For example, the service had recently provided a meeting with a physiotherapist who gave information on pelvic floor exercises.

For both new and existing staff, the service provided them with expert-led webinars and resources to help them in their role. Both clinical and non-clinical staff had access to Microsoft Teams groups where staff could request for support or answers to queries on demand; share best practice; and receive updates. All staff had protected time for study, continuing professional development and mandatory training. In addition, the service held an annual conference for all staff. Leaders told us this collaboration and coming together of the teams was an opportunity to share learning, communicate any changes and re-iterate the service mission.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service had a designated infection, prevention and control (IPC) lead and staff had completed relevant training. Risk assessments and audits were completed, and actions taken to mitigate risks. The service had effective oversight of the external cleaning companies used to ensure cleaning schedules were followed and cleanliness met the required standard.

We observed the clinic premises were visibly clean. Handwashing facilities including liquid soap, hand gel and paper towels were available in the clinic consultation rooms. Clinicians used personal protective equipment (PPE) such as aprons and gloves when required and single use equipment, which was disposed of in line with national guidance. The service had arrangements in place to manage healthcare waste and staff were aware of the action to take in event of sharps or contamination injury.

Doctors, pharmacists and nurses prescribed medicines to patients and gave advice on medicines in line with legal requirements and current national guidance. Where there was a different approach taken from national guidance, there was a clear rationale for this that protected patient safety. For example, the service prescribed some medicines that were ‘off label’ such as testosterone which was used to treat menopausal women experiencing low libido (Hypoactive Sexual Desire Disorder - HSDD). ‘Off label’ prescribing means that the medicine has a license for treating some conditions, but the medicine is being used in a way that is different to that described in the licence. Treating patients with off label medicines is higher risk than treating patients with licensed medicines, because these medicines may not have been assessed for safety, quality and efficacy for the condition they are being used to treat. Staff explained that as with all consultations, patients were given a full explanation of the medicine’s purpose, the intended benefits, and any potential risks associated with the medicine. In addition, the service had template patient letters which were automatically generated when clinicians prescribed an off label medicine, which informed patients of this.

We discussed with staff about the prescribing of high doses of hormone replacement therapy (HRT). Staff explained they prescribed the lowest dose of hormone replacement therapy to control symptoms for patients but sometimes this meant prescribing higher than the labelled medicine doses to treat their symptoms. In addition, leaders told us they used HRT as treatment for conditions such as osteoporosis and for cardiovascular benefits and told us they looked to guidance from global experts in relation to protecting future health.

The vast majority of prescriptions issued by the service for patients were for hormone replacement therapy, however staff explained occasionally they prescribed antibiotics and treatments for migraines. The service had a limited medicines formulary from which clinicians could prescribe. There was a drop-down list of medicines on the clinical IT system for prescriptions which could not be overridden without senior clinical approval. The service carried out regular medicines audits to ensure prescribing was safe. The service had a clinical lead for medicines management in place who maintained lists of every medicine prescribed and reviewed these periodically to check that the prescriptions were appropriate.

The service had a policy and processes in place for receiving and disseminating national medicines safety alerts. These alerts were reviewed for relevance by senior clinicians and cascaded to staff as appropriate for information and action. Safety alerts were also discussed as part of clinical meetings.

As part of our assessment, a Care Quality Commission GP Specialist Advisor undertook searches of patient records on the service’s clinical IT system. We reviewed the clinical records of 10 patients selected at random on the clinical system. We reviewed the ‘patient journey’ of these 10 patients including their first appointment with the service, their diagnosis and treatment, and ongoing follow-up consultations.

Our review found staff kept clear, detailed, and accurate patient clinical records. Patient medical history, examinations, investigations, and diagnoses were recorded. Patient concerns or preferences regarding treatment and information about the risks and benefits of treatment were documented, including potential side effects of medication. We found appropriate systems were in place for patient blood tests including ongoing periodic blood tests to ensure medicines continued to be appropriate and safe to prescribe. We also saw doctors regularly reviewed patients’ medicines to confirm they were treating their conditions effectively.

As part of this assessment CQC requested feedback from patients of Newson Clinic. The results of CQC collated data showed 88% of patients were positive about their experience of using the service; 8% reported a negative experience; and 4% reported a mixed experience with both positive and negative aspects. The vast majority of patients were positive about their treatment and the benefits they experienced of the medication they had been prescribed. Patients reporting negative experiences of the service told us they were concerned about the high levels of oestrogen they had been prescribed; side effects of medication which included bleeding; and some patients were concerned their medication had promoted cancer.