Revealed: Allegations which prompted the authorities to close Goodwood Court Surgery down

This is one of the claims made by the health body when its lawyer asked magistrates to immediately close Goodwood Court Medical Centre's doors.

Brighton magistrates Rosalind Buchan, Anne Rumble and Joanne Dawson found sufficient evidence to grant the order, under section 30 of the Health and Social Care Act 2008, on June 9 after hearing an application from Pravin Fernando, the barrister acting on behalf of the CQC.

The Argus reported the decision last month but has now obtained full details of the evidence put forward against the Cromwell Road centre in Hove which prompted the closure.

The documents were presented during a hearing in open court when the ruling was imposed but have only just been made available after this newspaper made a series of requests.

During a surprise inspection on Monday, June 8, inspectors found an "unqualified practitioner" was employed by Dr Andrew Mark Watts for locum, or temporary GP, cover and had seen nine patients that morning. This can mean anyone who is not a fully qualified doctor.

The court papers said: "Their [the patients'] lives, health and wellbeing were at risk both during and as a result of their consultation. This is because the unqualified practitioner was not trained to provide those consultations and was working in an unsupervised capacity."

A specialist adviser for the CQC reviewed the records of the patients in question and found "all patients needed further clinical reviews to ensure their safety".

According to the CQC, two inspectors and three specialist advisors found out-of-date medicines in the fridge with "no systems in place to ensure they were safe for use" and staff had not been "subject to appropriate criminal records checks before commencing employment or working as locums," during their first unannounced inspection.

On that occasion inspectors claimed there was "insufficient GP cover to meet 10,006 patients," leaving Dr Watts as the only GP on duty because a locum phoned in sick. There was a backlog of repeat prescriptions - such as insulin to treat diabetes - waiting to be signed off and a long list of hospital and other medical correspondence which needed attention.

Dr Watts, of Brighton, was present during the court hearing and the surgery was given 28 days to appeal the decision. The deadline closed on Friday and no appeal had been lodged, according to staff at both Brighton Magistrates' Court and Brighton County Court. [weds 15/7]

When approached by The Argus Dr Watts said he was unable to comment further at present but added: "My first priority was the patients and I am pleased there has been a positive outcome by working with Charter Medical Centre to resolve the situation."

A 34-year-old mother-to-be, and former Goodwood Court patient, said she was not surprised when she learned of the allegations when speaking to The Argus this week. She added: "It was always difficult to get an appointment. But Dr Watts was a really nice doctor."

Dr Rob Mockett, a partner at Eaton Place Surgery in Brighton before it closed earlier this year who now acts as a locum, said generally GP practices are struggling with low morale and facing problems because of a bureaucratic system which overloads doctors.

Dr Abubakr Ali Kambal Osman, who ran the surgery with Dr Watts, currently has temporary conditions placed on his licence to practise by the General Medical Council (GMC) while a series of hearings continue. According to documents held by the GMC, Dr Watts is also currently the subject of similar conditions.

The surgery remains closed but patients are instead attending Charter Medical Centre, in nearby Davigdor Road.

The centre will initially help out for a year and NHS England has provided extra resources to cope with the increased number of patients. Medical records are transferred automatically.

For information call Charter Medical Centre on 01273 770555.

OUT-OF-DATE MEDICINE AND STAFF SHORTAGES LED TO SURGERY CLOSURE

JUST over a month ago Goodwood Court Medical Centre suddenly closed its doors – but no one really knew why. 

Blinds were pulled and signs were pinned to an outside notice board. It had been urgently shut down after the Care Quality Commission (CQC) secured a court order, and NHS England was working fast to find alternative options for patients. 

Under section 30 of the Health and Social Care Act 2008, the registration of the medical centre and its providers – Dr Andrew Mark Watts and Dr Abubakr Ali Kambal Osman – was cancelled by Brighton magistrates as it appeared there would be a “serious risk to a person’s life, health or well-being” unless the order was made. 

Dr Watts “had not engaged with NHS England” and prescriptions had “not been actioned when needed”, the Care Quality Commission (CQC) alleged when it asked to close the Cromwell Road centre, The Argus later discovered. 

But still very little detail was available and it was not clear what may have happened to warrant such drastic action. 

Confused patients – a number of whom still spoke highly of the care they had received from their doctors there – were asking questions.

It took some time to find out the answers. The CQC was unable to comment in more detail until the appeal deadline passed on Friday. 

Previously, a spokesman said the CQC brought forward its recent inspection and had acted on patients' concerns when it visited the centre in January last year. It will publish a full and detailed report in due course. 

Staff at Brighton Magistrates’ Court initially told The Argus it could not release documents presented in open court during the application for closure. 

Eventually, after a series of requests made by this newspaper, the full extent of the allegations made against the surgery was released.

The CQC’s court application – presented to magistrates when it asked for the surgery to be closed indefinitely – revealed a catalogue of claims on staff shortages, a backlog in paper work, out of date medicine and, at one point, patients unknowingly being seen by an unqualified doctor. 

The unannounced inspections responded to concerns raised by staff at the Brighton and Hove Clinical Commissioning Group, NHS England and the Local Medical Committee, the papers said.

“Concerns included the breakdown of the partnership, staffing levels, specifically GP cover, lack of patient engagement at the practice and poor practice reviews recorded on NHS Choices. NHS England’s concerns were subsequently corroborated by CQC research and data analysis,” the court application claimed. 

Two inspectors and three specialist advisors – a doctor, a nurse and a practice manager – found matters which represented “unsafe practice that presented serious risks to patients’ lives, health and wellbeing”. 

Staff told inspectors “large numbers of repeat prescriptions” were waiting to be signed off or reviewed, which may have left patients without vital medication in the first unannounced visit on June 4. There was a backlog of more than 60 hospital letters and other correspondence, like pathology results, which had not been looked at, the CQC also alleged. 

Out-of-date medicines found in the fridge had not been checked for expiry dates and temperatures were not being monitored, the application said, putting patients at risk – because there was no system in place to check they were safe for use. 

Criminal record checks had not been properly carried out on staff, who were not supervised when they had direct contact with patients, the documents said. 

Dr Watts accepted the findings and said he would rectify the situation, the application said, but a second surprise visit on June 8 found steps taken to address the serious concerns may causing “even greater risk” and no appropriate action had been taken. 

This included employing an “unqualified practitioner” to provide locum cover, who saw nine patients before inspectors had arrived. 

The application claims Dr Watts said reception staff were to advise patients they were not seeing a qualified doctor, but reception staff denied this. All the patients had their treatment and advice reviewed to prevent further risk. 

NHS England said Dr Watts had “failed” to engage with a package of support offered and told the CQC he was in “considerable debt to locum services”.

It said the CQC considered there was no likelihood of an “adequate response by Dr Watts to ensure patient lives, health and wellbeing are no longer at risk” in explaining its rationale for the decision to urgently close the practice down. 

When The Argus first reported the closure, the NHS Choices website featured scores of negative reviews from patients complaining about a lack of appointments and declining service. Some patients said problems should have been investigated earlier.

Former air hostess Amber John, 37, now of Portslade, first registered with the practice in 1995 but claimed she complained in 2011 after her repeat prescriptions for treating mental health conditions including anxiety and bipolar disorder came late. She said there was “no urgency”.

Hove MP Peter Kyle also questioned whether the CQC could have acted sooner. 

Nicola Fisher, 41, a patient of 20 years, defended the surgery. She said: “I have no complaints about them at all. Dr Watts has always been very kind and caring and goes the extra mile to help.”

The doctors and the surgery had the right to appeal the claims and the closure order but no appeal was lodged, court staff said told The Argus on Friday.