Dr Cotterell and Partners

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