Background to this inspection
Updated
23 February 2024
Dr Cotterell and Partners is located in Thrapston at:
Nene Valley Surgery
Green Lane
Thrapston
Kettering
Northamptonshire
NN14 4QL
The practice has an onsite dispensary that was visited as part of the inspection.
The provider is registered with CQC to deliver the Regulated Activities, diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.
The practice is situated within the NHS Northamptonshire Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 7,260. This is part of a contract held with NHS England.
The practice is part of a wider network of GP practices, East Northants Primary Care Network (PCN), that enables them to work with other practices in the area to deliver care.
Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 10th decile (10 of 10). The lower the decile, the more deprived the practice population is relative to others.
According to the latest available data, the ethnic make-up of the practice area is 96% White, 2% Mixed, 1% Asian, 1% Black, and 1% Other.
The age distribution of the practice population has a lower than average number of patients under 49 years and a higher number of patients aged 50 to 79 years compared to the local and national averages.
The practice has 3 GP partners and a physician associate. The nursing team consists of 2 nurse practitioners, 2 practice nurses and a nurse associate. There are 3 dispensers led by a dispensing manager. The GPs are supported at the practice by a team of reception/administration staff. At the time of the inspection the provider was in the process of recruiting a practice manager to provide managerial oversight.
The practice is open between 8am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.
Extended access is provided locally by The East Northants GP Extended Access Service, where late evening and weekend appointments are available.
When the practice is closed, out of hours services can be accessed via the NHS 111 service.
Updated
23 February 2024
We carried out an announced comprehensive inspection) at Dr Cotterell and Partners, also known as Nene Valley Surgery on 8 August 2023. Overall, the practice is rated as requires improvement.
Safe - requires improvement
Effective - requires improvement
Caring - good
Responsive - requires improvement
Well-led - requires improvement,
Following our previous inspection on 16 February 2016, the practice was rated good overall and for all key questions.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Cotterell and Partners on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this inspection to follow up concerns reported to us.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A short site visit.
Our findings
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 found that:
- Remote reviews of the clinical record system demonstrated that medicine reviews were not always completed comprehensively and safety alerts had not always been responded to.
- Processes were in place to manage significant events with learning points identified. However, staff reported they were not always informed of the outcome of significant event investigations.
- The uptake for cervical screening was below the 80% target set by the UK Health Security Agency.
- There was minimal quality improvement activity. The practice had put an action plan in place. However, at the time of the inspection it had not been fully implemented.
- Feedback from patients via the National GP Patient survey was negative regarding telephone access and appointment booking.
- The practice had taken some actions to improve telephone access and appointment booking and had plans to change their telephony system. However, it was too soon to assess the impact of these measures.
- Policies and procedures were in place and accessible to staff to govern activity in the practice. There was a lack of oversight to ensure policies and procedures regarding medicines management and safe management of patients was applied.
- The practice had worked with the Northamptonshire Integrated Care Board and identified actions to be taken to make changes to the practice. They had implemented a Quality Improvement Action Plan to monitor and complete the actions.
- The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse.
- The practice had systems in place to keep all clinical staff up to date. Staff had access to clinical templates and National Institute for Health and Care Excellence (NICE) best practice guidelines.
We found breaches of regulations. The provider must:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
The areas where the provider should make improvements are:
- Continue to take measures to improve the uptake of cervical screening.
- Embed the quality improvement action plans that had been developed.
- Continue to take actions to improve patient satisfaction in relation to access and appointment booking.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Health Care