Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Urgent Care Centre Blackpool on 14 March 2017. Overall the service is rated as good.

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

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

We identified the following areas of outstanding practice:

• The organisation had implemented an End of Life care pathway in conjunction with the Hospice at Home Team. There was a direct referral route for all patients across the Fylde Coast requiring access to the Hospice at Home provision. The service was a tri-partnership between the hospice, FCMS and two local CCGs (Clinical Commissioning Groups) that delivered a unique approach to unscheduled care overnight, reacting to prevent avoidable admissions at the end of life.
• The organisation worked with the ambulance service to reduce hospital admissions and had made some significant changes to how work is distributed around the local healthcare economy. For example in one week 203 ambulance cases were assessed and 186 (91%) were deflected to more appropriate services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Patients attending the Urgent care centre were triaged (a process to group injured or ill people based upon their need for medical treatment) by front line staff. The service had access to interpreter services if required.

We spent time in the reception area observing how patients were assessed. We saw staff were attentive in how they spoke with patients. They took time to listen to what people were saying to them. Assessments were made using a patient ‘pathway’ (a process used to carry out a clinical assessment of the patients presenting needs).

We spoke with a number of patients at the time of the inspection the inspection process. In general patients were satisfied with the service and treatment they had received. One patient told us, “I have used the service before. All the staff are pleasant and it’s very organised”. Two other patients told us they had arrived at the time they had been provided by the call centre for a consultation. One told us, “The time I arrived was the time I was given, but I did have to wait for another forty minutes. I think they were busy”. Another patient told us, “It would be helpful if staff told you there would be a wait. I think people understand when it’s busy, but being kept informed would help”.

Following assessment a decision is made as to where patients will receive treatment or support. Some patients were assessed to go to NHS Accident and Emergency Department. Other patients used the services of the Urgent Care Centre.