AMS Clinic Manchester

Updated 21 August 2019

AMS Clinic Limited is an independent circumcision provider which is registered in Bradford, West Yorkshire to operate from locations in Bradford and Manchester. The Manchester based service was established in April 2017 and operates from accommodation within Cheetham Hill Medical Centre, 244 Cheetham Hill Road, Manchester, Lancashire, M8 8UP. The website address for the clinic is www.amsclinic.co.uk.

The clinic provides circumcision to patients aged from two weeks up to two years of age for both cultural and religious reasons. Patients also have access to post-procedural reviews at the clinic and access to an aftercare helpline available 24 hours a day.

The clinic operates from Cheetham Hill Medical Centre, a modern two-storey purpose-built building which is easily accessible for those bringing children or young people to the clinic. For example, it has level floor surfaces, automated doors and onsite parking available. There is also dedicated parking for wheelchair users or those with limited mobility.

AMS Clinic Manchester have a service agreement in place with the GP practice who operate from Cheetham Hill Medical Centre and utilise two rooms located on the ground floor (minor surgery room and consultation room) for the delivery of services. They also have access to ancillary areas such as waiting areas and public toilets.

The clinic is led by three directors (male) who have each been identified a specific area to lead on. The registered manager is one of the directors who is the managing director. The second director leads on staffing and rotas and the third on clinical areas including staff shortages.

AMS Clinic Manchester provides one to two sessions per clinic. Clinics are currently held on alternate Saturdays.

How we inspected this service

• Looked at the systems in place relating to safety and governance of the service.
• Spoke with the GP host practice regarding safety processes within the building.
• Explored clinical oversight and how decisions were made.
• Spoke with staff.
• Reviewed feedback from patients via in-house surveys and online comments.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 21 August 2019

This service is rated as Good overall.

The service had previously been inspected in September 2017 and was found to be providing services in accordance with relevant regulations. However, at that time independent providers of regulated activities were not rated by the Care Quality Commission.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at AMS Clinic Manchester on 29 July 2019 as part of our inspection programme.

The clinic provides circumcision to patients aged from two weeks up to two years of age for both cultural and religious reasons. Patients also have access to post-procedural reviews at the clinic and access to an aftercare helpline available 24 hours a day.

One of the directors of the clinic is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the clinic is run.

The clinic made use of patient feedback to monitor and improve the service. They produced their own surveys and regularly monitored feedback through google review.

Our key findings were:

• The clinic was offered on a private, fee paying basis only and was accessible to people who chose to use it.
• Circumcision procedures were safely managed and there were effective levels of patient support and aftercare.
• The clinic had developed materials for parents which explained the procedure and outlined clearly the recovery process.
• Parents received daily text messages providing advice for 13 days following the procedure to outline what to expect and give advice about aftercare.
• The clinic had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members. However, at the time of our inspection there had been no incidents recorded at the Manchester clinic.
• There were systems, processes and practices in place to safeguard patients from abuse.
• The clinic always communicated with the GP service with which patients were registered via letters sent with the parents following the procedure.
• There was a clear leadership structure, with governance frameworks which supported the delivery of quality care.
• Communication between staff was effective with regular documented meetings across both sites.

The areas where the provider should make improvements are:

• Review and improve the process for communicating with the patient’s own GP following the procedure.
• Review and improve the process for the documentation of medical indemnity and staff immunity status.
• Review the systems in place for direct clinical observation to assess surgical technique.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care