Olive Medical Practice

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

At our last assessment, we rated this key question as inadequate. This rating remains in place, and all scores remain the same. This assessment only focused on the circumcision clinic aspect of the service, and only relevant quality statements were assessed.

The service was in breach of legal regulation in relation to good governance.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We only assessed the circumcision clinic aspect of this quality statement.

The patient records we examined did not contain all the required information. All the required information had not been completed in any of the 22 records we examined. It was not always possible to determine the relationship between the infant and the person signing the consent form. The clinic told us they performed circumcisions on infants weighing 6lb and over, but the weight was never recorded. In 1 record, the infant’s date of birth was not recorded. The clinic’s literature stated the procedure was carried out on infants between the ages of 1 week and 6 months, although they verbally told us the maximum age was 3 months. Not having a date of birth recorded meant there was no evidence the procedure was being carried out safely in line with practice guidelines. Consent from 2 parents was not routinely recorded, and pain scores were never recorded.

The GP and nurse told us that parents occasionally wanted to observe the procedure, but this had not happened for several months. They told us they noted the records if a parent observed. We were at the practice while a clinic was taking place, and a parent observed the procedure. This had not been recorded on the patient’s records.

We did not have assurance of the accuracy of some records kept. The practice provided us with patient feedback forms following clinics in April 2025. For 1 clinic date they provided us with more forms that the number of patients or parents that attended the clinic. For another date they sent us feedback forms for a date a clinic had not been running. Neither the GP nor nurse could explain this discrepancy. The nurse confirmed that they completed all the feedback forms, and they did not include any patient or parent details as they did not always want to be identified.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We only assessed the circumcision clinic aspect of this quality statement.

We saw no evidence of the clinic being involved in any learning, improvement or innovation.

The GP told us they carried out regular audits, and the provided us with all the audits they held. They told us these had been completed for the purposes of their appraisals. We saw a clinical audit carried out between January and March 2023 which stated of 50 infants undergoing circumcision between those dates there had been no incidences of bleeding and on 1 occasion an infant developed an infection. No audits had been carried out following this date. Prior to this a clinical audit had been carried out on 3 August 2021. This stated standards were met with regards to infection control and there were “very few” complications during and after the procedure. It gave no further information and did not document how may procedures had been carried, how many complications there were, or what the timeframe of the audit was.

The GP told us there had been no significant events since 2019 when a complication led to an infant needing a blood transfusion and further surgery. We saw the record, and the GP told us this had been recorded for their appraisal and not recorded as a formal significant event for the practice.