Background to this inspection
Updated
28 February 2020
Audlem Medical Practice is a designated rural practice and is located at 16 Cheshire Street, Audlem Crewe CW3 0AH.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening
procedures, maternity and midwifery services and treatment of disease, disorder or injury.
Audlem Medical Practice is situated within the South Cheshire Clinical Commissioning Group (CCG) and provides services to 4,768 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
The practice has three female GPs, two male GPs, one GP registrar, two nurse practitioners, administration and reception staff and a practice management team. The practice is part of the Nantwich and Rural primary care network.
There are higher than average number of older patients compared to the national average. The practice population is made up of patients older than the national averages. For example, 31% of people are over 65 years compared to a national average of 17%. Fifty-two per cent
of the patient population has a long-standing health condition which is lower than the CCG average of 58%. Life expectancy for both males and females is around the CCG and national average of 79 years for males and 83 years for females.
The National General Practice Profile states that 99% of the practice population is white British. Information published by Public Health England rates the level of deprivation within the practice population group as eight, on a scale of one to ten. Level one represents the highest
levels of deprivation and level ten the lowest.
Updated
28 February 2020
We carried out a comprehensive inspection of Audlem Medical Practice on 19 December 2018. We rated the practice Good overall but Requires Improvement for providing safe services because there were breaches of regulations. The breaches were:
- Regulation 12 Safe Care and Treatment, as the provider could not demonstrate the clinical reason why some medicines had been prescribed. The provider had failed to ensure that clinical records were maintained. A record of the consultation, outcome and treatment had not been recorded in patients’ clinical records. There was no system in place to audit clinical records to offer assurance that patients care and treatment was safe and appropriate.
- Regulation 13 Safeguarding, as some clinicians had not received up to date safeguarding training appropriate to their role.
We also recommended that the practice should:
- Continue to monitor the level of exception reporting at the practice and review changes made to the recall system to offer assurance that more patients are being reviewed and receiving appropriate treatment.
- The safeguarding policy and procedure should be reviewed and amended to include information and guidance with regard to female genital mutilation (FGM), modern slavery and child sexual exploitation.
- Regular reviews of the new system being put in place to offer a structured and formal monitoring and supervision system for the advanced nurse practitioners (ANPs) and salaried GPs should take place to offer assurance that the treatment being provided is safe and appropriate.
- The system in place to monitor and check that patient group directives (PGDs) were appropriately authorised to enable staff to administer medicines should be reviewed to ensure all have the required authorisation.
- Suitable infection control training should be provided to the designated infection control lead.
At this desk based follow up inspection 6 February 2020, we found that the provider had satisfactorily addressed these areas and therefore the practice is now rated as good for providing safe services.
We based our judgement of the quality of care at this service on a combination of:
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care