Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Care UK (NHS 111 London), Unit 1, Square One, Navigator Park, Southall Lane, UB2 5NH on 13 and 14 March 2017, at its single site location.

Our key findings were as follows:

Care UK (NHS 111 London) (the provider/the service) provided a safe, effective, caring, responsive and well-led service to a diverse population in London. Overall, the provider was rated as good.

• There was an open and transparent approach to safety and an effective system in place to report and record significant events. Staff knew how to raise concerns, understood the need to report incidents and considered the organisation a supportive, culture. The provider maintained a risk register and held regular internal and external governance meetings.
• The service was monitored against a National Minimum Data Set (MDS) and Key Performance Indicators (KPIs). The data provided information to the provider and commissioners about the level of service provided.
• Staff had been trained and were monitored to ensure they used NHS Pathways safely and effectively (NHS Pathways is a licensed computer-based operating system that provides a suite of clinical assessments for triaging telephone calls from patients based on the symptoms they report when they call).

• Patients using the service were supported effectively during the telephone triage process and consent was sought. We observed staff treated patients with compassion and respect.

• Staff took action to safeguard patients and were aware of the process to make safeguarding referrals. Safeguarding systems and processes were in place to safeguard both children and adults at risk of harm or abuse, including calls from children and frequent callers to the service.

• The provider was responsive and acted on patients’ complaints effectively and feedback was welcomed by the provider and used to improve the service.

• There was visible leadership with an emphasis on continuous improvement and development of the service. Staff felt supported by the management team.

• The provider was aware of, and complied with, the Duty of Candour. Staff told us there was a culture of openness and transparency.

We saw one area of outstanding practice.

• People are protected by a strong comprehensive safety system that identifies opportunities to learn and shares that learning internally and externally.

There were areas where the provider should make improvements:

• Continue to address the challenges of recruiting substantive staff and the high reliance on agency staff to ensure adequate numbers of skilled staff are available to provide a safe and effective service.
• Improve the process for documenting discussions, decisions and actions for internal meetings for audit purposes, including but not limited to, appraisals and development meetings.
• Consider ways to engage with a variety of patient representative groups.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice