Newbury Street Practice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Patients at practice were not always receiving the assessments and interventions required to ensure effective care was delivered. Patients with long term conditions had not received routine monitoring tests and diagnoses were not always recorded accurately.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The patients were not always receiving the assessments, including tests, they required to ensure effective care. We identified some patients with potentially undiagnosed conditions where required testing had not taken place in line with national standards. The practice’s record had the information these patients required further diagnostic tests, but had not acted on this information.

Nursing staff informed us they had the guidance and training to assess patients’ needs, including long term conditions. However, we undertook searches on the provider’s clinical system which identified 100 patients who had potential undiagnosed chronic kidney disease. 4 out of 5 patient records we reviewed confirmed there were risks associated with a lack of diagnoses. Lead clinicians were not aware of the extent of this risk when we presented these findings to them for their feedback.

There were templates for assessing patients’ ongoing needs, including for the management of long-term conditions. However, there were insufficient processes to ensure appropriate diagnoses and assessments of patients’ conditions took place.

The management of patients’ long-term conditions did not always meet national guidance requirements. Specifically, some patients with asthma were not cared for appropriately following exacerbation of their condition. Patients reported improved access to care and treatment, including for their routine long term condition reviews.

Nursing staff told us they had tools to manage the recall of patients with long term conditions. However lead GPs had not ensured appropriate improvements to clinical care following previous CQC inspection. We identified there were significant numbers of patients who had not received care in line with guidance for their conditions.

There were systems to recall patients for reviews and tests required for the management of their conditions. However, many patients were not receiving the interventions they needed regarding the management of their conditions and the monitoring needed to ensure safe prescribing of their medicines. For example, clinical searches identified that out of 999 patients on the Asthma register, 48 had 2 or more courses of rescue steroids in the 12 months prior to the inspection. We reviewed 5 of these patients in detail and identified none had been followed up to check their response to treatment following exacerbation of their Asthma within a week of the prescribing (as required by national guidance). Out of 487 patients prescribed medication for the treatment of Hyperthyroidism, 11 were overdue thyroid function tests. We reviewed 5 of these patients in detail and identified 4 had not been monitored in line with national guidance. There were 105 patients identified as receiving a prescription for aldosterone antagonist and Angiotensin-converting enzyme/ Angiotensin II receptor blockers (ACEI/ARB) medicines, used in the treatment of specific conditions. We reviewed 5 patient records in detail and identified none had been monitored in line with national guidance.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.