Archived: NCL South Hub

Updated 4 April 2019

The North Central London (NCL) South Hub was registered with CQC in October 2016 and is the out of hour’s service for the London boroughs of Camden and Islington. The service is located at:

St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE and offers telephone clinical assessments with GPs and nurses, GP home visits; and face to face consultations. The base houses patient consultation rooms, the visiting GPs dispatch function and managerial office space.

NCL South Hub shares patient reception, waiting area and some clinical space with a co-located GP surgery. The remainder of the building and the hospital external areas are the responsibility of other health care providers.

The service’s administrative headquarters are located at St Charles Hospital, Exmoor Street, London W10 6DZ (patient consultations do not take place from this location). During our inspection we visited both sites.

The service at St Pancras is provided for registered and non registered patients and those requiring immediately necessary care when GP practices are closed; namely overnight, during weekends, bank holidays and when GP practices are closed for training. North Central London (NCL) South Hub serves approximately 470,000 people who are registered at general practices within the London Boroughs of Camden and Islington.

The NCL South Hub staffing team includes an operations manager, medical director, clinical leads,  service manager, operations co-ordinators, fleet co-ordinator, despatchers, receptionists, call handling staff, drivers, nurses and GPs. The service employs sessional (self-employed contractor) GPs directly and occasionally through agencies.

The service operating hours are seven days a week from 6:30pm to 8am and 24 hours at weekends and bank holidays. Patients access the service via the NHS 111 telephone service. The service does not normally accommodate walk in patients.

The NCL Integrated Urgent Care (IUC) Service is delivered in partnership with Barndoc Healthcare Limited who is a material subcontractor.  Together the two organisations work in partnership to deliver a single IUC service across North Central London which includes the boroughs of Camden, Islington, Barnet, Enfield and Haringey.

As part of the North Central London Integrated Urgent Care Service, LCWUCC also operates the NHS 111 service covering the Inner North West London boroughs of Kensington & Chelsea, Westminster and Hammersmith & Fulham.

NCL South Hub is registered for the Regulated Activities of Transport services, triage and medical advice provided remotely; and Treatment of disease, disorder or injury.

The service’s website address is www.lcwucc.com/

Updated 4 April 2019

This service is rated as Good overall. (Previous inspection January 2018– Requires Improvement).

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, follow up inspection at North Central London (NCL) South Hub on 22 and 24 January 2019. CQC previously inspected the service on 23 and 25 January 2018 and asked the provider to make improvements because although the care being provided was effective, caring and responsive, it was not being provided in accordance with the relevant regulations relating to safe and well led care.

At our previous inspection we found the provider had breached Regulation 12 (1) (Safe care and treatment) and Regulation 17 (1) (Good governance) of the Health and Social Care Act 2008. This was because staff checks were not being undertaken to the appropriate level and because the provider’s decision not to carry oxygen in home visit vehicles had not been sufficiently risk assessed. We also noted the absence of appropriate systems for sharing learning from significant events and for ensuring safety alerts improved patient safety.

The service wrote to us to tell us what they would do to make improvements and we undertook this comprehensive inspection to check the service had followed their plan and to confirm they had met the legal requirements.

At this inspection we found:

•Action had been taken since our last inspection in January 2018, such that when safety incidents happened, systems were in place to ensure learning was shared and processes improved.

•Action had been taken since our last inspection, such that Disclosure and Barring Service (DBS) checks for home visit drivers were now being undertaken to the level stipulated in the provider’s Recruitment Policy. DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable.

•The service ensured care and treatment was delivered according to evidence-based guidelines.

•Staff involved and treated people with compassion, kindness, dignity and respect.

•There was a strong focus on continuous learning and improvement at all levels of the organisation.

•The leadership, governance and culture of the service promoted the delivery of high-quality person-centred care.

The areas where the provider should make improvements are:

•Continue to carry out medicines audits to ensure prescribing patterns are in line with best practice guidelines for safe prescribing.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care