Castletown Medical Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our previous inspection, the practice was rated good for providing an effective service. At this assessment we have rated the practice as good for providing an effective service. Through our clinical searches completed we saw that the service delivered evidence-based care. They mostly monitored and improved outcomes for patients by carrying out clinical audits. We saw that the most available data showed that childhood immunisations were in line with national targets, however cervical screening was below these.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received no specific feedback from patients in this area. However, we had some concerns regarding the low take up of cervical screening at the practice and the monitoring of patient’s medication which would affect their experience of care.

The provider was the clinical lead at the practice, they discussed with us at interview how patients’ needs were assessed and delivered in line with current legislation.

In relation to outcomes we saw from data from NHS Digital - Cervical Screening Programme Coverage Statistics that for the percentage of persons eligible for cervical cancer screening who were screened adequately within 3.5 years for persons aged 25 to 49, and within 5.5 years for persons aged 50 to 64, at 30/6/2023 the practice had achieved 74.3% - the expected percentage was 80%. The practice told us this indicator had improved and provided us with unvalidated data from their own clinical system giving the achieved percentage at the time of assessment as women aged 25-49 – 77% and 50-64 – 78%. Child immunisations were above the 90% minimum vaccination rate recommended by the World Health Organisation (WHO). From our remote searches of clinical records we sampled 5 medication reviews of 110 identified in the last 3 months and there were no issues with the reviews. We sampled records of how the practice managed long term medical conditions. We found no issues with the monitoring asthma and diabetes care. However, from 8 patients with chronic kidney disease (CKD) we sampled 5 records and found four of those patients were not on the CKD register. The management of their condition was not in line with National Institute for Healthcare Excellence (NICE) guidance as there was no evidence of urine albumin to creatine ration (ACR) which helps identify kidney disease as a complication of diabetes. However, we found whilst carrying out searches of the practice’s clinical system that there were 198 tasks outstanding. Some of these dated back to August 2023. For example, 1 was a request to refer a patient to secondary care, with others relating to blood tests and letters and correspondence. The practice had failed to ensure that these tasks were audited and actioned.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We received no specific feedback from patients in this area. However, we had some concerns regarding the low take up of cervical screening at the practice and the monitoring of patient’s medication which would affect their experience of care.

The lead GP explained the process for monitoring clinical outcomes at the practice. We discussed our clinical searches with the lead GP and pharmacist.

We saw the processes for clinical audit and safety incidents at the practice. The clinical searches of the practice patient records system showed patient medication reviews and long-term condition management were mostly positive.

We had some concerns with the patient outcome data regarding care which we looked at. The cervical screening rate was lower than expected. There were higher levels of prescribing of antibacterial prescription items compared to the expected number.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.