Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the out of hours service provided by City and Hackney Urgent Healthcare Social Enterprise (CHUHSE) at Homerton Hospital on 9 March 2017. Overall the service is rated as good.

Our key findings across all the areas we inspected were as follows:

• Risks to patients were assessed and well managed.
• There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
• Patients’ care needs were assessed and delivered in a timely way according to need. The service met the National Quality Requirements.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• There was a system in place that enabled staff access to patient records, and the out of hours staff provided other services, for example the local GP and hospital, with information following contact with patients as was appropriate.
• The service managed patients’ care and treatment in a timely way.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Consider providing non clinical staff, including drivers, with basic life support (BLS) training to recognise and respond appropriately to medical emergencies.
• Review facilities for patients with hearing impairment.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice