CQC places Leicester City, Leicestershire and Rutland Out of Hours service into Special Measures

England’s Chief Inspector of General Practice has placed a Leicestershire and Rutland Out of Hours service into special measures following an inspection by the Care Quality Commission.

The Care Quality Commission has found the quality of care at Leicester City, Leicestershire and Rutland Out of Hours in Smith Way, Enderby, Leicester, to be Inadequate following an inspection carried out in March 2015. A full report of the inspection has been published today.

The out-of-hours service provides care to patients who require urgent medical care from GPs and nurses outside of normal GP hours. The provider employs the services of 254 GPs, nurses, health care assistants and support staff who are engaged on a sessional basis to deliver care to patients.

The service operates county wide from 6.30pm until 8am Monday to Thursday, and 6.30pm Friday until 8am Monday, and all public holidays. It is provided by Central Nottinghamshire Clinical Services Ltd.

Under CQC’s new programme of inspections, all of England’s GP practices and Out of Hours services are being given a rating according to whether they are safe, effective, caring, responsive and well led.

Specifically, inspectors found the service inadequate for providing safe, effective and responsive services and being well led. It required improvement for providing caring services.

The report highlights a number of areas where improvements must be made including:

• Staff must be trained appropriately in safeguarding and policies must be implemented at all of the sites, rather than just centrally.
• The service must ensure that the patient queues for definitive clinical assessment, face to face consultations in a primary care centre and face to face consultations for home visits are robustly monitored and managed to ensure patient care does not suffer.
• The service must implement a new regime regarding serious incidents by communicating to staff and training them on identifying and reporting.
• Medicines management policies and procedures need to be implemented across all sites. Staff must carry out audits of medication stock and whether it is in date.
• Policies, procedures and checklists must be implemented for clinical equipment to ensure that it is available and working correctly.
• A supernumerary member of staff must be used on all shifts to monitor patient queues with the authority to allocate resources to ensure patients are being assessed within given timescales.
• A clear leadership structure must be implemented and staff made aware of their lines of management.
• Clinical supervision needs to take place for both doctors and nurses.

CQC is working closely with NHS England and the three Leicester, Leicestershire and Rutland Clinical Commissioning Groups to support the service, while it addresses the issues identified by the inspection.

Janet Williamson, Deputy Chief Inspector of General Practice and Dentistry in CQC’s Central region said:

“It is important that the people who use Leicester City, Leicestershire and Rutland Out of Hours service rely on getting the high quality care which everyone is entitled to receive.

“GP Out of Hours services face particular challenges in providing safe, compassionate care. Patients are often unfamiliar to staff, and staff do not always have access to their medical records. Often these services have a large workforce where staff may not know each other well. Cases can be complex and urgent and must be handled effectively in order to ensure the best patient care is delivered.

"Although the patients we met told us they were treated with dignity and respect, we also found that care and treatment was not always delivered in line with best practice.

“We know that Leicester City, Leicestershire and Rutland Out of Hours has acknowledged the areas where action must be taken. We have found significant areas of concern, which is why we are placing the service into special measures - so opening the way to support from NHS England among others.

“We will continue to monitor this service and we will inspect again in six months to check whether improvements have been made. I am hopeful that the service will do what is required for the sake of its patients, but if we find that the service remains inadequate, we will consider taking further action.”

Ends

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