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Modality Circumcision Service - Birmingham Good

Inspection Summary


Overall summary & rating

Good

Updated 30 October 2019

We carried out an announced comprehensive inspection of Modality Circumcision Service - Birmingham in May 2019. While no breaches of legal requirements were found, the service was rated as requires improvement for providing safe services. This was because we identified some areas where the provider should make improvements.

We carried out a focussed desk-based inspection of Modality Circumcision Service - Birmingham on 7 October 2019 to check that the provider had made improvements in line with our recommendations. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Modality Circumcision Service - Birmingham on our website at www.cqc.org.uk.

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

  • Since our comprehensive inspection in May 2019, the provider had reviewed and improved their processes for the management of medicines used off label.
  • The provider had reviewed and improved their processes for communicating with the patient’s usual GP after the procedure.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care.

Inspection areas

Safe

Good

Updated 30 October 2019

We previously rated Modality Circumcision Service - Birmingham as Requires improvement for providing Safe services. Following this desk-based inspection, the service is now rated as Good for providing Safe services.

Information to deliver safe care and treatment

  • During our inspection in May 2019 we found the service did not have effective processes in place for communicating with the patient’s usual GP. During this desk-based inspection in October 2019 we reviewed information the provider sent us that showed they had reviewed and improved their processes, following the inspection in May 2019 for communicating with the patient’s GP.
  • The provider had amended their processes so that at the time of booking an appointment the service asked all patients/parents for contact details for their registered GP and for their consent to share the letter detailing the procedure carried out in the circumcision clinic with their GP. The service recorded the patients/parents’ consent/dissent in the patient’s clinical record.
  • The provider arranged for the letter to be sent to the GP by the clinic’s administrator following the appointment if the patient had consented.
  • If the patient/parents did not consent to share information with the GP, the clinic provided the patient/carer with a letter containing the details of the procedure. The clinic had considered safeguarding arrangements if the patient or parents did not consent to share information with the GP and staff had concerns.

Safe and appropriate use of medicines

  • During our inspection in May 2019 we found the service did not have effective arrangements for managing the use of off label medicines. During this desk-based inspection we found the provider had taken appropriate action following the inspection in May 2019 to review and improve their systems for managing unlicensed/off label medicines.
  • The provider had formalised arrangements by introducing a policy which was shared with all relevant staff. The policy included clear responsibilities for clinicians, for example, clinicians could only prescribe off label medicines when there was sufficient evidence for their use. Clinicians had to provide patients (or their parents or carers) with sufficient information about the medicines they proposed to prescribe to allow them to make an informed decision and clinicians had to document consent in the patient records for the use of the medicine.

Effective

Good

Updated 30 October 2019

Caring

Good

Updated 30 October 2019

Responsive

Good

Updated 30 October 2019

Well-led

Good

Updated 30 October 2019