This practice is rated as Good overall. At the previous inspection in October 2015 the practice were rated as good overall.

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Newnham Walk Surgery on 31 January 2019 as part of our inspection programme.

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 concluded that:

• Patients were able to access care and treatment in a timely way and the practice achieved higher performance than both the CCG and England average for access through the GP National Patient Survey.
• Quality Outcomes Framework data was generally in line with, or above, local and national averages. Exception reporting data was generally lower than both the CCG and England averages.
• Data from Public Health England showed the practice performance for cancer screening was mixed; for breast and bowel screening the practice was in line with CCG and national average but for cervical screening uptake was lower than the CCG and England averages.
• Staff we spoke with were positive about working at the practice and the leadership and management team.
• The practice had a number of links and regular contact with a variety of support groups and services such as eating disorder clinics, university medical services and Improving Access to Psychological Therapies.
• The practice employed a GP Psychotherapist who held two morning clinics at the practice each week.
• The practice assessed and responded to the needs of their population groups.
• Patients with spoke with were positive about the practice, the services offered and the care and treatment delivered at the practice.
• The practice’s performance in the GP National Patient Survey was higher than CCG and England averages.

However, we also found that:

• Some legal requirements were not met.
• The practice’s process for managing patient safety alerts was not always effective.
• The practice did not have complete oversight of all high-risk medicine monitoring prior to prescribing.
• The practice’s prescribing of co-amoxiclav, cephalosporins and quinolones was higher than the CCG and England averages.
• The practice had only identified approximately 0.2% of their practice patient list as carers, following out inspection; following our inspection, the practice reviewed their carers register and found they could identify approximately 0.7% of their patients as carers.
• The practice did not have an active patient participation group, there was a group of patients who were in contact by email, but this was not regular.

We rated the practice as requires improvement for providing safe services because:

• The practice’s process for managing patient safety alerts was not always effective.
• The practice did not have complete oversight of all high-risk medicine monitoring prior to prescribing.

The practice was rated as good for providing effective services overall and to all population groups apart from working aged people which was rated as requires improvement for providing effective services.

The practice was rated as requires improvement for providing effective services to working aged people because:

• The practice’s uptake of cervical screening was lower than both the CCG and England averages and significantly lower than the 80% national target rate set by Public Health England. Following our inspection, the practice took some action to try and improve uptake.

We rated the practice as good for providing caring, responsive and well-led services.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Continue to identify ways to encourage and improve the number of eligible patients attending for cervical screening.
• Review the carers register to ensure it is accurate and appropriate for the practice population.
• Continue to develop and encourage patient participation at the practice.
• Continue to monitor the prescribing levels of co-amoxiclav, cephalosporins and quinolones.
• Complete actions identified in the recent infection prevention and control audit.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We visited Newnham Walk Surgery on the 4 June 2015 and carried out a comprehensive inspection. Overall the practice is rated as good.

We found the practice to be safe, effective, caring, responsive to people’s needs and well-led. The quality of care experienced by older people, by people with long term conditions and by families, children and young people was good. Working age people, those in vulnerable circumstances and people experiencing poor mental health also received good quality care.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored and appropriately reviewed and addressed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• There was a strong learning culture within the practice. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Patients said they were treated with dignity and respect and were involved in their care and decisions about their treatment.

• The practice was safe for both patients and staff. Robust procedures helped to identify risks and where improvements could be made.

• The clinical staff at the practice provided effective consultations, care and treatment in line with recommended guidance.

• Information about services and how to complain was available to patients and easy to understand.

• The practice had good facilities and was well equipped to treat patient and meet their needs.

• Services provided met the needs of all population groups.

• The practice had strong visible leadership and staff were involved in the vision of providing high quality care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice