ELMS regularly review clinical performer performance, using:

    • Clinical Guardian system based on RCGP criteria, to provide formal and informed review of clinicians’ consultations, based on each ELMS clinician’s consultations within its Adastra clinical system. Each month a sample of each clinician’s consultations are audited by trained peer auditors; the percentage applied to each clinician’s consultations is based on the perceived risk associated with that clinician; and 

    • ELMS uses a manual audit programme to formally assess consultations recorded in EMIS rather than the Adastra based Clinical Guardian system. The process is based on the same RCGP criteria as that used for Clinical Guardian and reviews are conducted by ELMS Clinical Chair, Medical Lead and/or Nurse Adviser.

Consultations that demonstrate clinical behaviour that is at variance to best practice guidelines, including prescribing that is not in conformity to ELMMB guidelines is flagged for review by ELMS clinical performance review panel.

Feedback, and where necessary training and support are provided for the clinician and any performance issues are discussed at ELMS Clinical Governance meetings and any lessons learnt are shared with the individual clinician and where relevant, with all clinicians on an anonymised basis through ELMS monthly clinical bulletins.


Safeguarding audits take place on a weekly basis, where all cases where a safeguarding concern is highlighted are reviewed by ELMS safeguarding lead and actions are audited for appropriate referral and escalation. Remedial or supplementary action is taken if the audit identifies a need for the same.


ELMS has given the CCGs Medicines Management Teams access to our data to enable proactive analysis and discussion around our prescribing patterns. 


ELMS clinical leads undertake a number of clinical audits whose results are shared with clinical colleagues via ELMS Clinical Newsletter.

Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website