CQC places Peterborough Out-of-Hours service into Special Measures

England’s Chief Inspector of General Practice has placed a Cambridgeshire out-of-hours service into special measures following an inspection by the Care Quality Commission.

CQC inspectors found the out-of-hours service provided by Cambridgeshire Community Services NHS Trust in Peterborough to be Inadequate following the inspection in November.

A full report of the inspection has been published today.

The out-of-hours service provides urgent medical care outside of normal GP hours to a population of 188,000 people. The provider employs GPs, nurses, healthcare assistants and support staff based at the City Care Centre in Peterborough.

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.

Inspectors found the service inadequate for being safe, effective and well led. It was rated Good for providing caring services.

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

• The service used nurses to triage patients by telephone before referring patients to a GP, advanced nurse practitioner or emergency care practitioner. But the nurses did not have access to adequate guidance and there was no evidence that they had been properly trained to deal with these calls. 
• Staff files and recruitment procedures were not documented or governed thoroughly. A review of staff files demonstrated that staff were not always recruited in accordance with the trust policy and various information was either incomplete or missing.
• Inspectors were concerned that patients did not always receive effective and timely care and treatment. Response times for calls back to patients varied. Even though the service was not always meeting national requirements, there was no clear vision for improvement.

CQC shared its concerns with key stakeholders including Trust Development Authority, NHS England and Cambridgeshire and Peterborough CCG and the trust submitted an action plan which seeks to address the issues raised by the inspection team.

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

"We found that patients were at risk because systems were not always in place to keep them safe. The provider must ensure that all staff who triage patients have been adequately trained to make clinical decisions by telephone and have been assessed.

“The service must ensure that the time patients wait for thorough clinical assessment is properly monitored to ensure patient care does not suffer. There must be enough staff on site to keep people safe.

“Clear arrangements must be put in place to ensure that managers have effective oversight of the performance of the out-of-hours service at all times so that they can take appropriate action to minimise the risks to patients.

“It is important that the people who use the GP out-of-hours service for Peterborough and surrounding area can rely on getting the high quality care which everyone is entitled to.

"We will continue to monitor this service and we will inspect again in six months to check whether improvements have been made. I hope that the service will take the necessary steps, but if we find that the service remains inadequate, we will consider taking further action.”

Dr Neil Modha, Chief Clinical Officer, Cambridgeshire and Peterborough CCG said: “The CCG has worked closely with CCS since the inspection to ensure implementation of their recovery plan and we have been pleased with the progress and improvements in areas where quality of care were of concern. We will continue to monitor this progress so we can be assured that patients are receiving the high standard of out-of-hours care that we expect.”

Ends

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