This service is rated as Good overall (Previous inspection 9,10,12 April 2018 – Overall Good rating).

We carried out an announced comprehensive inspection at Partnership of East London Cooperatives Limited (Out of Hours Service) on 14 March 2019. Our inspection included a visit to the service’s King George’s hospital location.

This inspection was to confirm the provider had carried out their plan to meet the legal requirements in relation to breaches in regulations that we identified in our previous inspection on 9,10,12 April 2018. At that time the service was rated as good for safe, effective, caring and responsive services and was rated good overall. The service was rated as requires improvement for well led services because governance arrangements did not ensure the Hepatitis B status of doctors was on file or ensure all relevant people were involved in learning from significant events and safety alerts.

This report only covers our findings in relation to those areas where requirements had not previously been met. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Partnership of East London Cooperatives Limited (Out of Hours Service) on our website at www.cqc.org.uk/location/1-199811091.

The key questions are rated as:

Are services well-led? – Good

At this inspection we found:

• Action had been taken since our last inspection such that there were appropriate governance arrangements for ensuring the Hepatitis B status of all doctors was on file and for ensuring learning from significant events involved all relevant people.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Partnership of East London Co-operatives (PELC) Limited (NHS 111), on 16 March 2017. Overall the service is rated as good.

Our key findings were as follows:

• 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.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

This service is rated as Good overall (Previous inspection 3,6 and 20 March 2017– 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? – Requires Improvement

We carried out an announced comprehensive inspection at Partnership of East London Cooperatives Limited (Out of Hours Service) on 9,10,12 April 2018. Our inspection included a visit to the service’s headquarters and also to each of its five base locations.

This inspection was to confirm that the provider had carried out their plan to meet the legal requirements in relation to breaches in regulations that we identified in our previous inspection on 3,6,20 March 2017. At that time the service was rated as requires improvement for safe, effective and well led services; and rated overall as requires improvement. This report covers our findings in relation to those requirements and also in relation to additional improvements made since our last inspection.

At this inspection we found:

• Action had been taken since our last inspection such that medicines management and quality improvement governance arrangements had improved.
• However, we identified new concerns regarding governance arrangements for ensuring that the Hepatitis B status of doctors was kept up to date; and for ensuring that learning from significant events involved all relevant people.
• Action had been taken since our last inspection such that clinical audit was now being used to drive quality improvements.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• Patients said that they were treated with compassion, dignity and respect by reception staff and that clinicians involved them in decisions about their care and treatment.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• Patients’ care needs were assessed and delivered in a timely way according to need. The available data showed that the service consistently met the National Quality Requirements and exceeded the commissioner’s performance targets.
• 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 had good facilities and base locations were well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice