AMS Clinic

Updated 21 August 2019

AMS Clinic Limited is an independent circumcision provider which is registered in Bradford, West Yorkshire to operate from locations in Bradford and Manchester. The Bradford based service registered with the Care Quality Commission in February 2014 and operates from 72 Oak Lane, Bradford, West Yorkshire, BD9 4QX. The website address for the clinic is www.amsclinic.co.uk.

The clinic provides circumcision to patients aged from two weeks up to two years of age for both cultural and religious reasons. Patients also have access to post-procedural reviews at the clinic and access to an aftercare helpline available 24 hours a day.

The clinic operates across four floors. The reception and waiting area is located on the ground floor, with a dedicated private room for obtaining consent situated behind this area. Surgical procedures are carried out in the basement area of the clinic. Following the procedure, patients are taken to a private consultation/waiting room on the first floor and second floor to recover from treatment. The building is accessed from the pavement via two steps. However, the provider has installed a ramp to the rear of the premises for pushchairs, wheelchair users or those with limited mobility. There is on street parking outside of the clinic and a free car park located a short distance from the clinic.

The clinic is led by three directors (male) who have each been identified a specific area to lead on. The registered manager is one of the directors and they act as the managing director. The second director leads on staffing and rotas, and the third on clinical areas including staff shortages.

AMS Clinic provides one to two sessions per clinic. Clinics are currently held on Sundays.

How we inspected this service

• Looked at the systems in place relating to safety and governance of the service.
• Explored clinical oversight and how decisions were made.
• Spoke with staff.
• Reviewed feedback from patients via in-house surveys and online comments.
• Reviewed CQC comment cards.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 21 August 2019

This service is rated as Good overall.

The service had previously been inspected in November 2017 and was found to be providing services in accordance with relevant regulations. However, at that time independent providers of regulated activities were not rated by the Care Quality Commission.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at AMS Clinic Bradford on 30 June 2019 as part of our inspection programme.

The clinic provides circumcision to patients aged from two weeks up to two years of age for both cultural and religious reasons. Patients also have access to post-procedural reviews at the clinic and access to an aftercare helpline available 24 hours a day.

One of the directors of the clinic is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the clinic is run.

The clinic made use of patient feedback to monitor and improve the service. They produced their own surveys and regularly monitored feedback through google review.

In addition; we received nine Care Quality Commission comment cards. These were all very positive about the care delivered by the service.

Our key findings were:

• The clinic was offered on a private, fee paying basis only and was accessible to people who chose to use it.
• Circumcision procedures were safely managed and there were effective levels of patient support and aftercare.
• The clinic had developed materials for parents which explained the procedure and outlined clearly the recovery process.
• Parents received daily text messages providing advice for 13 days following the procedure to outline what to expect and give advice about aftercare.
• The clinic had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.
• There were systems, processes and practices in place to safeguard patients from abuse.
• The clinic always communicated with the GP service with which patients were registered via letters sent with the parents following the procedure.
• There was a clear leadership structure, with governance frameworks which supported the delivery of quality care.
• Communication between staff was effective with regular documented meetings across both sites.

The areas where the provider should make improvements are:

• Review and improve the process for communicating with the patient’s own GP following the procedure.
• Review and improve the process for the documentation of medical indemnity and staff immunity status.
• Review and improve the process for checking the oxygen supply.
• Review the systems in place for direct clinical observation to assess surgical technique.
• Review the arrangements for onsite access to the legionella risk assessment.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care