The Care Quality Commission
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Askern Medical Practice

Overall: Requires improvement read more about inspection ratings

The Askern Medical Centre, The White Wings Centre, Askern, Doncaster, South Yorkshire, DN6 0HZ (01302) 700378

Provided and run by:
AMP Healthcare Limited

All Inspections

During an assessment under our new approach

Askern Medical Practice an NHS GP practice which provides primary care services to patients in Doncaster from two locations, The White Wings Centre, Spa Pool Road Askern, DN6 0HZ and Mexbrough Medical Practice, Alagu Close, Mexborough, S64 9AE. The provider is registered with CQC to deliver the Regulated Activities: the treatment of disease, disorder or injury; diagnostic and screening procedures; maternity and midwifery services and surgical procedures. The practice is part of the NHS South Yorkshire Integrated Care Board (ICB). The patient population of about 7,500 patients. This is a part of a contract held with NHS England. The practice is part of a network of GP practices called the Doncaster North Primary Care Network (PCN). Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the second lowest decile (2 of 10). The lower the decile, the more deprived the practice. The last comprehensive inspection of this service took place in January 2016 when it was rated as good overall and for all of the key questions. We carried out further focused inspections in April and September 2021 following information of concern but these did not result in a change of ratings for the service. We carried out an assessment between 13 and 28 March 2024. The service has been rated as requires improvement overall and for the key questions caring, responsive and well-led. We found one breach of the legal regulations in relation to governance. This is because feedback from patients, staff, survey information and some processes regarding access to the practice were poor. Practice policies were not always followed, record keeping could be improved. We had concerns of the ability of staff to deliver person centred care from their feedback on their well-being. Safe and effective were rated as good. We have asked the provider for an action plan in response to the concerns found at this assessment.

24 September 2021

During an inspection looking at part of the service

We carried out an unannounced focused inspection of Askern Medical Practice on 24 September 2021. The inspection was carried out at Mexborough Medical Practice which is the branch surgery of Askern Medical Practice.

Previous inspection reports can be found by selecting the ‘all reports’ link for Askern Medical Practice on our website at www.cqc.org.uk.

Why we carried out this inspection

This inspection was a focused inspection following information of concern about patient safety that was disclosed to the Care Quality Commission (CQC). The information was that nurses without prescribing qualifications had been prescribing or amending prescriptions for patients with poor mental health. Concerns had also been raised about the training and supervision of a phlebotomist.

We have the power under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to carry out unannounced inspections. Due to the nature of the concerns that had been raised, and the potential serious impact on patient safety, we decided to carry out an unannounced focused inspection. We only inspected the areas of concern highlighted to us.

As this was a focused inspection no ratings have been given for any of the key questions. The ratings given in the previous rated inspections remain.

How we carried out the inspection

We attended Mexborough Medical Practice. The provider granted us permission to access their clinical computer system. We only accessed what was necessary in order for us to assess the accuracy of the concerns raised. We also spoke briefly to the lead GP and the operations manager.

Our findings

  • We found no evidence of nurses without prescribing qualifications prescribing or amending prescriptions.
  • We found the phlebotomist had completed a course in phlebotomy and had been supervised when carrying out the procedure.

Details of our findings and the evidence supporting our decisions are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

None

During an inspection looking at part of the service

The report was created as part of a pilot which looked at new and innovative ways of fulfilling Care Quality Commission’s (CQC) regulatory obligations and responding to risk in light of the Covid-19 pandemic and reducing the burden placed on practices by minimising the time inspection teams spend on site.

This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider. The assessment did not include on-site inspection and therefore the practice has not been rated or ratings from our previous inspection have not been reviewed.

The practice was last inspected in February 2020 when it was rated as requiring improvement overall (requires improvement for the safe and responsive key questions; good for the caring, effective and well-led key questions). We will follow up on the issues identified at the February 2020 during a further inspection later this year.

Background

We undertook a remote regulatory assessment on 8 April 2021 following receipt of information of concern. We focused our assessment on the safe and responsive key lines of enquiry.

During the assessment we reviewed the clinical record system for Askern Medical Practice and a sample of patient records. We also spoke with two GPs and reviewed information that we had asked the provider to send to us.

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we carried out the assessment
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We found that:

  • Appropriate processes were in place for the management of test results, clinical correspondence and repeat prescriptions
  • Staff were working within their range of competency
  • Feedback in relation to the minor surgery service for the period 1 April 2020 to 31 March 2021 was 100% positive.
  • Home visit requests were dealt with appropriately and as soon as clinically necessary, either by a practice GP following triage by the on-call GP or by referral to the local Emergency Care Practitioner Service
  • The practice offered a mix of remote, face to face and online consultations. If a clinician felt a patient needed to be seen in person following a remote consultation then arrangements were made to facilitate a face to face appointment, usually on the same day.
  • Patient satisfaction regarding telephone access and access to appointments is poor. This is an issue that we identified at our inspection of the service in February 2020. We will consider this issue further during a subsequent inspection of the service.

Whilst we found no breaches of regulations, the provider should:

  • Continue to look at ways of improving patient satisfaction and managing patient expectations regarding telephone access.

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

11 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Askern Medical Practice on 11 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it difficult to get through to the practice by telephone first thing in the morning to make an appointment. Urgent appointments are available the same day but often filled quickly.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.
  • Although audits had been carried out, we were told there was not a continuous quality improvement programme for future audit and patient review activity.

We saw three areas of outstanding practice:

  • The practice had engaged with the local traveller community and to improve access to healthcare services for them.  The lead GP won the Inclusivity Leader of the Year award 2014 from NHS Health Education England Regional Leadership Recognition Award (Yorkshire and the Humber) for this work.
  • The practice offered local high school students the opportunity to come into the practice and learn more about careers in primary care. The lead GP had won the Mentor/Coach of the Year 2015 from NHS Health Education England Regional Leadership Recognition Award (Yorkshire and t he Humber) for their work mentoring and coaching students applying to become healthcare professionals.
  • The practice held quarterly education sessions for patients and members of the PPG. Topics in the last year included social prescribing and befriending, common hand and eye consultant services for patients, bone and joint problems and the risks associated with addictive controlled drugs. Further events were planned for this year.

The areas where the provider should make improvement are:

  • Make arrangements for all staff to complete level one safeguarding childrens training as recommended in the Intercollegiate Guideline (ICG) “Safeguarding Children and Young People: roles and competences for health care staff” (2014).
  • Implement a procedure to monitor prescription pad use complying with NHS Protect Security of Prescription guidance.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice