Northampton and Earls Barton doctor in court today as CQC takes urgent enforcement action to cancel registration
The Care Quality Commission is to take a doctor and his surgery to court this morning (Friday, July 9) to as magistrates to cancel their registration after a damning inspection report.
Around 9,500 patients are served by the Earls Barton Medical Centre in Aggate Way and its branch surgery Penvale Park in East Hunsbury, Northampton.
Dr Muhmmad Imran Azizullah is the registered manager at both surgeries and, as such, is responsible for ensuring the surgeries' statutory obligations are met.
An inspection by the CQC - the independent regulator for medical care in England - that took place in April and was published on July 1 found serious failings at the surgery including a lack of clear systems and processes to keep patients safe, inadequate safeguarding processes, irregularities in recruitment and an absence of effective management that had impacted on the quality of care.
Some patients' medical records were being stored in a staff toilet and diagnoses of patients had been missed because of incorrect coding on computer systems. There were records of 781 new patient records awaiting summarisation and 2,570 new patient records that had not been completed with sufficient detail which meant that these patients’ medical history was not readily available to staff.
Admin staff without appropriate training were being expected to draft referrals to other services. Blood test results for patients prescribed blood thinning medications were not routinely recorded in patient records which meant GPs were potentially prescribing medicines without reviewing relevant blood test results.
Staff were not trained as chaperones, lacked up-to-date safeguarding training, and inspectors were not provided with evidence that staff had received mandatory vaccinations. Inspectors could not find out if equipment maintenance checks had been carried out and had worries over fire safety at both sites. Infection control measures were not always in place and, alarmingly, the practice did not have a COVID-19 specific risk assessment or measures in place to ensure staff and patients were kept safe from infection.
Cleaning schedules had not been completed for months at either site and an untrained receptionist was working unsupervised in the dispensary.
There were 16 patients who should have been coded as diabetic on the practice’s system due to blood test results, but they were not, meaning they had not received treatment for their condition, had not been adequately monitored nor appropriately referred and could be at risk of serious illness. There were 249 patients who had not been coded on the practice’s system for chronic kidney disease. Inspectors also found examples where test results which were considered abnormal under national guidance had been marked by a GP as satisfactory.
There were examples of ineffective monitoring of medicines, meaning patients were at serious risk of harm. A fridge containing vaccines was unsafe for use due to the temperatures being out of range.
Chief Inspector of Primary Medical Services and Integrated Care Dr Rosie Benneyworth immediately placed the surgery into special measures and ordered urgent improvements ahead of a re-inspection that took place at the end of June and the beginning of this month.
That report has not yet been published but it is expected to reveal that only cursory measures had been taken and that the improvement has not been quick enough to satisfy inspectors.
In similar circumstances other providers may have surrendered their provider registration, but this has not happened at Earls Barton.
So this morning the CQC have taken the highly unusual step of forcing asking magistrates to make a civil order to cancel both Dr Azizullah's registration and the registration of Earls Barton Medical Centre under section 30(1) of the Health and Social Care Act 2008.
Such orders are only applied for by the CQC in urgent and serious circumstances and they are one of the highest sanctions that can be imposed on a registered person. Cancellation normally follows considerable efforts to get registered persons to meet the legal requirements, including taking special measures.
The measures do not affect Dr Azizullah's fitness to practise as a doctor. He is still able to work as a GP but cannot take on the statutory role of registered manager at either Earls Barton or Penvale. Both surgeries can potentially still open but a new manager will have to be appointed as the registered person.
The surgeries are contracted by Northamptonshire Clinical Commissioning Group to provide GP services to both areas and, as such, the CCG is now responsible for continuity of service. It is not yet known if either surgery will open next week.
The CCG has been contacted for comment, but it is believed they have made arrangements to put in place a caretaker practice to take over care of patients.