This service is rated as Good overall. (Previous inspection 2 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? – Good

We carried out an announced comprehensive at Urgent Care Centre Newham General Hospital Trust on 30 July 2018 to follow up on breaches of regulations.

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• 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.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Review and monitor frequently attending older patients who may be vulnerable.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the GP out of hours service provided by Newham GP Cooperative Ltd at the Urgent Care Centre, Newham General Hospital Trust on 2 March 2017. Overall the service is rated as requires improvement.

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

• Risks to patients who used services were assessed, and staff described processes and procedures that kept patients safe, however the systems and processes to address these risks were not managed effectively.
• Patients’ care needs were assessed and delivered in a timely way according to their needs. 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.
• 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.
• We found that the overarching governance framework that supported the delivery of the strategy and good quality care was not always effective.
• 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 must make improvement are:

• Establish and operate effective systems and processes for the effective management of significant events.
• Establish and operate effective systems and processes for the effective management of safeguarding of patients from abuse.
• Establish and operate effective systems ensuring vehicles used by GPs for home visits are safe, fit for purpose and appropriately insured.

The areas where the provider should make improvement are:

• Review the requirements for sharps injury information to be present and visible in clinical rooms.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Newham GP Cooperative provides telephone advice, face-to-face consultations and home visits to people who require medical advice or treatment outside of normal GP working hours. The service provides out-of-hours cover for people who live in the London Borough of Newham.

Our inspection team included a CQC inspector, a GP, two specialist nurses and a person with experience of using services we call an ‘expert by experience’. Before our inspection we carried out an analysis of data which did not highlight areas of risk across the five key question areas.

There were a number of areas of good practice we found such as learning from incidents and an openness to develop the service quality. We also found calls were prioritised based on need and risk and that GPs were knowledgeable about the local population they served.

We also found that some systems were not formalised such as auditing of consultation notes, GP’s lone working procedures or the checking of equipment. Elsewhere we found that systems that were in place were not being correctly followed such as with medicines management and criminal records bureau (CRB) or disclosure and barring service (DBS) checks.