One patient received 96 prescriptions when limit was six
Some patients on the Isle of Man have been put at increased risk because their GP surgeries aren’t monitoring the medication they are taking.
That’s the finding from the Care Quality Commission which has reviewed all 13 practices across the Island.
Reports for all have been published today (23 January) which determine whether the external regulator deems them to be Safe, Effective, Responsive, Caring and Well-led.
Issues, highlighted at a number of practices, have now been escalated to the Department of Health and Social Care.
Last year CQC inspectors investigated a number of patient records to determine how practices dealt with the management of long-term conditions.
At some they found that clinicians didn’t have effective oversight of patients – noting that assessments, follow-up appointments and medication reviews were not being carried out.
At Hailwood Medical Practice, in Governors Hill, it was recorded that several patients taking ‘high-risk’ medication for high blood pressure hadn’t been reviewed for years.
As a result some people were at risk of ‘life threatening’ complications - one patient was still being prescribed the medication despite a request from a specialist, the year before, for it to be stopped.
At Peel Medical Centre a similar investigation showed that some patients had not been monitored since 2016 with four out of five patients studied overdue a medication review.
One patient was said to be at ‘particular risk’ due to having had abnormal test results at a previous monitoring appointment which had not been reviewed, or escalated, since.
At Village Walk, in Onchan, four patients were found to have a missed diagnosis of diabetes and at Kensington Group Practice the surgery had a ‘reluctance’ to diagnose patients as diabetic.
Instead some were referred to as having ‘impaired glucose’ meaning they were not receiving all required monitoring and were not always invited for things like diabetic eye screening.
At the Southern Group Practice investigators found a short acting reliver inhaler, used to treat asthma, was being overprescribed noting that the overprescribing of such inhalers is associated with an increased risk of asthma death.
Nine patients were prescribed more than 12 inhalers in 12 months and some continued to receive the medication despite reaching their prescription limit.
One individual was recorded as having a 1000 per cent overuse after receiving 26 prescriptions when the maximum was six.
Patients, using the southern surgery, were also prescribed controlled drugs without review – in one case a person had a limit of six prescription issues but had been able to obtain 96 without being reassessed.
Issues were also recorded at some surgeries concerning the prescribing competence of staff, supervision of prescribers and the fact that not all staff had appropriate authorisation for the supplying and administering of medication.
The Care Quality Commission has now recommended that practices improve the management of their patients with long term conditions to ensure they receive all required monitoring, assessments, diagnoses, follow-up appointments and medication reviews.
You can find all the CQC reports HERE.