CQC Cancels Kent GP’s Registration

The Care Quality Commission (CQC) has taken action to protect the safety and welfare of people by cancelling the registration of a GP in Chatham, Kent following serious concerns about patient safety at the practice.

The CQC’s decision to cancel the registration means that Dr Stephen Lawrence can no longer legally provide primary medical services at the practice in St Mary’s Island, Chatham, Kent. However, on 20 February 2018 a new provider was registered with the Care Quality Commission to provide general practice services from the St Mary’s Island Surgery site. CQC, NHS Medway Clinical Commissioning Group and NHS England have worked together to restore patient safety since they became aware of the situation with Dr Lawrence.

Inspectors took the action regarding Dr Lawrence because they had serious concerns about the service and the risks to people using it.

The CQC first inspected St Mary’s Island Surgery in December 2015 and rated the practice as ‘inadequate’ overall.  As a result the practice was placed in special measures.  The CQC inspected again in September 2016 and took the practice out of Special Measures as a result of the improvements the practice had made and rated it ‘‘good’ overall and for each of CQC’s key questions.

A further unannounced comprehensive inspection took place in January 2018, which was carried out in response to concerns that had been raised to CQC.  The CQC found the concerns were such that on the 29 January 2018 immediate conditions were imposed on the Dr Lawrence’s registration with the Care Quality Commission.

Key Concerns

  • Systems to safeguard children from abuse were not effective.
  • There were no administration/reception staff working at the practice.  Temporary reception staff, who had come from other practices to help, had not had an induction.
  • Correspondence was not dealt with in a timely manner, large quantities of correspondence were awaiting inputting onto patients’ records.
  • Medicine management was unsafe. Emergency medicines were out of date. The oxygen cylinder was empty.
  • Significant events had not been reported.  The practice did not have an effective system for receiving and acting on safety alerts.
  • GPs did not have access to the proper information technology tools to help make the best decisions for their patients’ treatment and care.
  • Patient care was not well co-ordinated, including end of life care.
  • Patients’ records and the coding of patients’ records were not up to date so staff were not always able to identify patients’ conditions and meet their needs.
  • Patients were not referred to secondary care, nor were referrals from secondary care, dealt with in a timely manner.
  • There were failings in the practice’s compliance with the Data Protection Act 1998.
  • Care and treatment for patients with multiple long-term conditions and patients approaching the end of life was not always coordinated with other
    services.
  • Patients did not always receive care and treatment from the practice within an acceptable timescale for their needs.
  • Some complaints from patients were not acknowledged.
  • Governance arrangements were insufficient, ineffectively implemented and were compounded by the regular absence of the GP.
  • Significant issues that threatened the delivery of safe care were not identified or adequately managed.
  • There had been no recent staff meetings and there were no patient participation groups.
  • There was no evidence of systems and processes for learning, continuous improvement and innovation within the practice.

CQC’s Deputy Chief Inspector of General Practice, Ruth Rankine, said:  “Enforcement action to close a service is not something that the CQC takes lightly. Where we find that patients are at significant risk, as we did in this case, we have no choice but to work with our partner agencies in order to take action to protect the safety and welfare of the public.”

“In this instance, given the seriousness of what we found on inspection, we are confident we took the right decision to protect people. When necessary, we will use our powers to do what it takes to make sure patients and the public are protected.”

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