Newington Road Surgery Limited Also known as Newington Road Surgery

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed all 7 quality statements from this key question. Leaders used people’s feedback along with other forms of evidence, to enhance access for people facing challenges in obtaining care. Services were designed to be accessible and timely for those most likely to encounter difficulties in accessing healthcare. As part of these improvements, changes were implemented with the phone line system to streamline access. Most of the patient feedback CQC received reflected negatively on the care and treatment provided. Specific concerns included delays in processing prescriptions, challenges in obtaining a prescription after an urgent referral from 111, and difficulties booking appointments. There was also feedback regarding the increased reliance on locum doctors, with reports of uncontrolled asthma and blood pressure management. Additionally, some patients highlighted issues with staff compassion and poor communication. One patient reported that their medication had been stopped multiple times without prior consultation. We recognise the pressure that practices are currently working under, and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. Although we saw the practice had taken action to improve access, this was not yet reflected in the GP patient survey data.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most of the patient feedback CQC received reflected negatively on the care and treatment provided. Specific concerns included delays in processing prescriptions, challenges in obtaining a prescription after an urgent referral from 111, and difficulties booking appointments. There was also feedback regarding the increased reliance on locum doctors, with reports of uncontrolled asthma and blood pressure management. Additionally, some patients highlighted issues with staff compassion and poor communication. One patient reported that their medication had been stopped multiple times without prior consultation. The results of the most recent national GP patient survey showed the percentage of respondents who stated that during their last GP appointment they were involved as much as they wanted to be in decisions about their care and treatment was 84%, compared to then national average of 91%. Results from the practice’s survey undertaken in July 2024, showed 88% rated the service as very good or good. This was a 10% improvement when compared to the practice’s survey results from January 2024.

The practice understood the needs of its local population and had developed services in response to those needs. Leaders were able to demonstrate a good understanding of the practice’s demographics and the challenges they faced. The provider sent us evidence demonstrating ongoing monitoring of the availability of same day and routine appointments for patients. The provider adopted a cloud-based telephone system, which enabled patients to request a call back and also allowed leaders to monitor access to the practice. Leaders told us the work that had been conducted to monitor the demand versus the supply of appointments and that they had made efforts to ensure that more appointments were made available to meet the practice population needs. The practice recently achieved accreditations as an Armed Forces Veteran Friendly GP Practice. The practice had a dedicated clinician with specialist knowledge of military related health conditions and veteran specific health services. Leaders told us this would help provide enhanced support for veterans and military families and improve access to specialised services.

Staff and leaders acknowledged their population was in an area of high deprivation. They demonstrated an understanding of processes aimed at ensuring patients received coordinated and integrated care. Staff also shared reasonable adjustments that were made to support patients in accessing care, along with the ability to offer choices wherever possible to accommodate individual needs. Patients in vulnerable circumstances, including those with no fixed abode, were able to register with the practice. Staff understood the importance of flexibility, informed choice and continuity of care. All parents or guardians calling with concerns about a child were offered a same day appointment when necessary.

There were no concerns raised by partners regarding care provision, integration and continuity.

The practice was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs and complex medical issues. Multi-disciplinary working helped provide effective safeguarding support and end of life care. The practice maintained registers of different patient groups, including those with a learning disability, those with mental health concerns and those requiring palliative care. Evidence reviewed demonstrated the provider organised and delivered services to meet patient needs. All staff had completed training in equality and diversity.

Most of the patient feedback CQC received reflected negatively on the care and treatment provided. Specific concerns included delays in processing prescriptions, challenges in obtaining a prescription after an urgent referral from 111, and difficulties booking appointments. There was also feedback regarding the increased reliance on locum doctors, with reports of uncontrolled asthma and blood pressure management. Additionally, some patients highlighted issues with staff compassion and poor communication. One patient reported that their medication had been stopped multiple times without prior consultation. Another mentioned there were inaccuracies in their medical records that had not been correct, and a further concern was raised regarding incorrect information about staff on the practice’s website. We reviewed the practice’s website and found that the staff information was accurate and up to date.

Interpreting and translation services were used for patients whose first language was not English and for patients who used British Sign Language. Patient information leaflets and notices were available in the patient waiting area which told patients how to access support groups and organisations. Patients who had difficulty with reading, writing or using digital services were supported with accessible information.

There were processes in place to support patients with learning disabilities, allowing them to bring a carer or family member to their appointments. Systems ensured that patient’s individual needs for accessible information were identified and recorded. The patient waiting area was well-maintained and offered a wide range of information for patients and carers.

Feedback from 3 people included comments about not receiving a response to their complaint.

Staff told us they kept people updated on the outcome of concerns reported. We reviewed a sample of complaint records and saw people had been provided with a response in a timely manner. We were told by staff that learning was shared in practice meetings. Staff we spoke shared examples of learning from complaints that had been investigated.

Information on how patients could raise a complaint was accessible in the waiting area and on the practice’s website. We reviewed a sample of complaints and noted they were investigated, with responses provided to the complainant. Although processes to monitor and improve services were in place, we identified discrepancies between the practice’s complaints policy and its actual implementation. According to the policy, both verbal and written complaints should be recorded in a complaints log to facilitate the identification of trends. However, we found that this procedure was not consistently followed. Staff informed us that written complaints were stored in a folder rather than being logged on a spreadsheet, as outlined in the policy. Additionally, they did not maintain a record of verbal complaints, which was also contrary to the policy. While complaints forwarded to the head office were tracked using a spreadsheet, there was no equivalent system in place for complaints handled directly by staff within the practice.

The national GP patient survey received 110 responses, representing a completion rate of 30%. The results of the national GP patient survey indicated that patient satisfaction across 6 indicates related to access was below the national averages. These indicators included overall experience of contacting the practice, ease of contacting the practice by phone, ease of contacting the practice via the website, helpfulness of the reception and administrative team, whether patients understood the next steps after contacting the practice and whether patients knew the next steps within 2 days of contacting the practice. Some reported long waiting times of the phone and those who managed to speak to staff often found that no appointments were available. Additionally, some patients expressed concerns about delays in processing prescriptions. One patient highlighted an incident where their prescription, following an urgent referral from 111, was not signed off in a timely manner. Improvements had been made following our last inspection regarding using patient feedback to identify improvements. Results from the practice’s survey undertaken in July 2024, showed 88% rated the service as very good or good. This was a 10% improvement when compared to the practice’s survey results from January 2024.

Leaders demonstrated awareness of the challenges related to patient access and took steps to address and improve it. We were informed the primary theme of patient feedback they received was regarding difficulties with telephone access, in response, the practice implemented a new telephone system that enabled the analysis of call data to streamline the patient experience. Leaders explained they regularly reviewed this data to identify peak call times and have added extra reception staff during these periods to improve call response times. Leaders also told us other feedback they received from patients was regarding lack of face-to-face appointments. In response, leaders reported they now have a stable, regular team of GPs on site, offering pre-bookable and reserved same day appointments. Leaders also noted these changes have led to positive feedback from patients. Some staff reported improvements over the past 12 months, stating the current staffing levels were sufficient. However, others expressed a need for more clinical and non-clinical staff. Despite acknowledging a high workload, staff explained that processes were in place to identify capacity issues, and they felt these were being addressed. Additionally, we were informed of recent recruitment efforts to manage demand, along with ongoing efforts to hire more clinical staff.

The practice’s telephone lines were open Monday to Friday 8am to 6.30pm. There was information available for patients to support them to understand how to access services, including when the practice was closed. There were arrangements with other providers to deliver services to patients outside of the practice’s working hours. Staff told us they ensured emergency appointments were available for patients who needed to be seen urgently. The practice offered a range of appointment types to suit different needs. For example, face to face, telephone and home visits. Patients with most urgent needs had their care and treatment prioritised. Results from the practice’s survey undertaken in July 2024, showed 88% rated the service as very good or good. This was a 10% improvement when compared to the practice’s survey results from January 2024. We saw call monitoring data that the practice collected for June and July 2024. This showed, on average, patients waited around 6 minutes in the telephone queue. The practice received an average of 1160 calls per week of which 91% were answered.

While we received feedback regarding prescription delays, difficulties in getting prescriptions signed off, challenges in obtaining appointments, increased use of locums and concerns about uncontrolled asthma and blood pressure, and some staff showing a lack of compassion and poor communication, we did not find evidence to suggest negative experiences related to equity in experience and outcome. Additionally, one individual reported their medication being stopped multiple times without prior consultation. However, the information we collected did not indicate any disparities in the quality of services provided or in the outcomes for different groups of patients. We reviewed a piece of feedback concerning wheelchair access to the premises. During our inspection, we observed that the premises was accessible. Additionally, we noted that leaders had investigated and responded to the complaint, implementing measures to improve the patient experience.

Staff told us that reasonable adjustments were made for patients who experienced difficulties accessing services. Translation services were available for those who required them, and a hearing loop was available at reception for patients who were hard of hearing. Additionally, staff informed us that a private room was available upon request for patients who needed a confidential conversation with reception staff.

The practice complied with legal equality and human rights requirements by avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes. The practice had processes to ensure inclusivity and responsiveness to changes in patients’ gender identity, name and title. In addition, patients with learning disabilities were provided with annual health reviews, ensuring continuous monitoring and support for their needs. To enhance accessibility, patients with learning disabilities were given the option to attend appointments accompanied by a family member or carer, and home visits were offered when necessary, ensuring equitable access to healthcare services. The practice also demonstrated a commitment to patients in vulnerable circumstances, including people without a fixed address. The practice did not have an established Patient Participation Group (PPG). However, the practice actively sought patient feedback through the NHS Friends and Family Test and by reviewing complaints. Staff said they were making efforts to encourage patients to join and participate in the PPG with the aim to better understand the views of patients and to promote equity in healthcare experiences and outcomes for all patients.

Patient feedback did not raise any concerns regarding planning for the future.

Staff and leaders demonstrated a clear awareness of the systems in place to support patients requiring end of life care. They outlined that a register of patients in need of such care was maintained, ensuring a structured and organised approach to their needs. Multi-disciplinary meetings were held regularly, involving relevant healthcare professionals.

Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were made in line with relevant legislation and were appropriate. We reviewed 2 DNACPR decisions and saw they were correctly signed by an appropriate clinician. Records indicated that an assessment of the patient’s mental capacity had been carried out, ensuring the process was in line with legal requirements.