A GP practice which unexpectedly closed a branch in July was not carrying out DBS checks on employees and showed no evidence of supervising non-medically qualified staff who were working in a clinical role.

Cross Plains Health Centre, which has since merged with Millstream Medical Centre, announced on July 15 it would be shutting its Tidworth branch just four days later.

Bosses said the move was made in the face of “considerable staffing challenges” and the practice continued to operate at sites in Larkhill and Durrington.

Now a report published by the Care Quality Commission (CQC) has revealed that the practice was inspected in the days and weeks leading up to the closure, after which it was found to be performing badly in three of five categories and given an ‘inadequate’ rating overall.

An initial review was carried out on June 26, with a “further comprehensive inspection” undertaken on July 9, ahead of the report’s publication on November 4.

The report found that three legal requirements were breached relating to safe care and treatment, staffing and the employment of fit and proper people.

Outlining the main issues, the report noted: “There was no evidence that non-medically qualified staff working in a clinical role were adequately supervised, mentored and monitored.

“There was evidence that some patients who had been seen by non-medically qualified staff had not been adequately reviewed and seen by a qualified clinician.

“Risks to patients were not adequately assessed and actions had not been implemented to mitigate those risks.

“Inadequate recruitment checks were undertaken so that the practice could assure themselves that staff employed to undertake clinical roles were of good character and that they had immunity to the hepatitis B virus.”

The report added that “the vaccine fridge at the Durrington site was not locked and was stored in a room which was not always kept locked” and “staff who required a Disclosure and Barring Service check had not had this undertaken prior to starting employment.”

It also pointed out that risk assessments were not in place where staff had not received DBS checks, and there was no record that one member of staff had immunity to the hepatitis B vaccine.

The practice was told it must make improvements in six areas relating to safety, governance and recruitment. This included competing an independent review of the patient records and consultation documents for all patients who have been seen by staff working in roles other than GPs, under condition two of the CQC report.

Since the inspection Cross Plain Health Centre has merged with Millstream Medical Centre, formally doing so on October 1. It is continuing to provide services from three sites at Larkhill, Durrington and Salisbury.

Dr Richard Sandford-Hill, clinical chair at Wiltshire Clinical Commissioning Group (CCG), says required actions set out by inspectors are now being carried out.

He said: “We have seen and read the CQC report published on November 4 following their inspection of Cross Plain Health Centre in June 2019.

“Our priority is always to ensure the clinical safety of our patients and in line with condition two on the registered provider set out in the CQC report, Wiltshire CCG has arranged for an independent review of the patient records.

“This review will focus on the patient groups identified by the CQC and will be completed in phases to provide assurance regarding the standard of care provided at Cross Plain Health Centre.

“Where previous patients have proactively chosen to register with another practice, their medical notes will be accessed for review at their new practice. Patients should note that they do not need to take any action.

“We understand that patients may have questions or concerns as a result of the CQC report or medical notes review and these should be directed to our Patient Advice and Liaison Service (PALS) team on 0300 123 2103.

“The lines are open Monday – Friday, 9am-5pm, or you can email wccg.complaintsandpals.nhs.net.”