Archived: Houghton Primary Care Centre

Updated 8 December 2017

Vocare Limited provides urgent care for minor injuries and illnesses to residents in the Sunderland area from three centres: These are the Urgent Care Centres at:

• Houghton Primary Care Centre, Brinkburn, Crescent, Houghton Le Spring, Tyne And Wear, DH4 5HB.
• Minor Injuries Unit, Bunny Hill Centre, Hylton Lane, Sunderland, Tyne And Wear, SR5 4BW.
• Minor Injuries Unit, Washington Primary Care Centre, Parkway, Washington, Tyne And Wear, NE38 7QZ.

We visited the headquarters for Vocare Ltd, which is Vocare House, Balliol Business Park, Benton Lane, Newcastle upon Tyne, NE12 8EW. We also visited Houghton Primary Care Centre

These services in the Sunderland area are commissioned by Sunderland Clinical Commissioning Group (CCG). They are managed and operated by the registered provider Vocare Limited, which is also known locally as Northern Doctors Urgent Care Limited.

Vocare is a provider of outsourced clinical healthcare services in collaboration with the NHS.

Vocare employs a clinical services manager and an operational manager who oversee the day to day running of the three urgent care and minor injuries units. They employ a number of GPs, advanced

nurse practitioners, nurse practitioners and junior nurse practitioners. There is also an operational team in place to support delivery of the service during opening hours.

Patients can access the service from open from 10am to 10pm Monday to Friday and 8am to 10pm Saturdays, Sundays and Bank Holidays. Calls to the service are handled by North East Ambulance Service (NEAS) via the 111 telephone number. Urgent Care Centre operates a triage model where all patients receive clinical telephone assessments. This prevents unnecessary journeys for patients and enables appropriate coordination of appointments according to clinical urgency and demand. Patients can also attend the service in person to make an appointment. There is no clinical triage prior to making an appointment through this method, but reception staff do have a generic assessment to help them identify those patients whose needs may be more urgent or those patients presenting with a medical emergency. The reception staff are provided by NHS Property Services as part of the contractual arrangements for the premises.

Updated 8 December 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection of Houghton Primary Care Centre on 10, 20, 21 and 30 January 2017 and 14 February 2017.

We rated the service as requiring improvement, and there were breaches of legal requirements. In particular, we found that staff had not received training related to the Mental Capacity Act (2005) and safeguarding children to the expected level. There was insufficient governance and oversight to provide assurance recruitment processes were safe and that action was taken to address areas of known concern.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet the above regulation.

This inspection was an unannounced focused inspection, carried out on 20 October 2017, to check whether the provider had taken steps to comply with the above legal requirements, and made other improvements we said they should since our last inspection.

Overall, the service is now rated as good.

The provider, Vocare Limited, provides urgent care for minor injuries and illnesses to residents in the Sunderland area from three centres. This report relates to one of these, Houghton Primary Care Centre. However, some data in the report relates to the overall performance across the three locations, where data was not available at location level. You can find the reports for the provider’s other locations by searching for Vocare Limited on our website at www.cqc.org.uk, and selecting the ‘all reports’ link for each location.

Our key findings were as follows:

• The service’s internal online training system had been redesigned and the sample of training records we looked at showed all clinical staff had recently carried out safeguarding training.
• The staff responsible for recruitment had been integrated into the human resource support team. This team supported regional and line managers with the administrative tasks associated with recruitment. The sample of recruitment records we looked at showed references had been obtained.
• Staff had completed training on safeguarding children (to the appropriate level) and the Mental Capacity Act. Arrangements were in place to contact GPs to request copies of training certificates where they had completed this externally to the service.
• Staff had received an appraisal within the last twelve months.
• The service had started to address cultural issues within the organisation. They recognised this was an ongoing challenge, and there was still further action needed to address staff morale and to promote a supportive culture.
• We found there were some instances where clinical staffing arrangements were lower than expected. There were short periods of time where, although other members of non-clinical staff were available, the clinical staffing level was at one member of staff.

At our previous inspection in January / February 2017, we said the service should review how they assess the needs of patients who attend in person to make an appointment to make sure risks to patients are assessed and well managed. At this inspection we found the service had not addressed this area. They had made no changes to the way they managed the risks to patients who attend in person to make an appointment.

Vocare Limited had produced a patient leaflet, which set out the types of minor illnesses and injuries patients could seek treatment for at the urgent care centres in Sunderland. This directed patients to inform reception if their symptoms changed or got worse whilst they were waiting for an appointment.

The areas where the provider should make improvements are:

• Review how they assess the needs of patients who attend in person to make an appointment to make sure risks to patients are assessed and well managed.

• Continue to make improvements in the way the service reviews, monitors and deploys the number, and mix of staff needed, to meet patients’ needs to demonstrate a safe environment is maintained for staff and patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice