Archived: Urgent Care Centre North Staffordshire

Updated 13 November 2018

The Urgent Care Centre (UCC) North Staffordshire is part of the Vocare Group, known locally as Staffordshire Doctors Urgent Care (SDUC). Vocare have approximately 2,000 employees and deliver GP Out -of- Hours (OOH) and urgent care services to approximately 9.2 million patients nationally. Vocare have recently been acquired by Totally Plc. SDUC also provides the OOH service and the NHS 111 service to approximately 1,200,000 patients the whole of Staffordshire. The population of Staffordshire includes the more deprived urban areas in and around Stoke-on-Trent as well as the more affluent areas in south Staffordshire with pockets of deprivation around Cannock, Tamworth and Burton upon Trent.

The service known as UCC North Staffordshire is a streaming (redirecting patients to appropriate care) service provided within the Emergency Department (ED) at The Royal Stoke University Hospital and within a nearby building used to see and treat patients who do not require emergency care. SDUC has provided a GP led urgent care centre service since August 2017, a service aimed at reducing the pressure on the emergency department by treating those patients. This service operates 24 hours a day, 365 days a year, and the local governance is managed within the UCC by a lead nurse and an operations manager and supported from the organisation’s headquarters at Staffordshire House, in Stoke-on-Trent. The service receives approximately 3,000 contacts per month from adult patients. Children are streamed by the Children's Emergency Department which is part of the hospital. On 10 September, the service relocated so that consultation rooms, supported by a reception area, are now situated in a separate building near the ED. The service has retained three rooms within the ED, one is a streaming room, one a triage room and one a spare consulting room to be used if the separate building was unavailable and to help with capacity during busy periods.

During our inspection we visited the headquarters of SDUC in Stoke-on-Trent and the ED at The Royal Stoke University Hospital.

Further details can be found by accessing the provider’s website at www.sduc.nhs.uk 

Updated 13 November 2018

This service is rated as good overall (previous inspection 04. 2018 – Inadequate).

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 inspection on 22 and 23 April 2018. Our overall rating for the service was inadequate and following discussions with North Staffordshire and Stoke Clinical Commissioning Groups, Vocare and The Royal Stoke Hospital, the provision of the streaming service was transferred to hospital staff until the required improvements could be made. We rated the service to be inadequate for providing safe, effective and well-led services; requires improvement for providing responsive services and good for providing caring services. We served warning notices for breaches in relation to Regulation 12: Safe Care and Treatment and Regulation 17: Good Governance. The hospital management team agreed to provide the service on a temporary basis until the provider could re-commence provision of the service. The transfer of the service back to the Urgent Care Centre North Staffordshire was completed on 10 September 2018.

At this inspection we found:

• Systems to safeguard vulnerable patients had been strengthened.
• There was a consistent approach for identifying risks, issues and implementation of mitigating actions.
• Processes to manage risks relating to shared learning from significant events and incidents were being used effectively.
• Emergency equipment and medicines were easily accessible to staff.
• Staff employed had the appropriate skills to treat patients accepted into the service.
• There was suitable pain relief medicine to treat acute pain.
• Clinicians were working to clear exclusion criteria; no inappropriate patients were found to have been accepted into the service.
• Prescriptions were securely stored and an effective system was in place that monitored their use.
• Patients’ care needs were assessed and delivered in a timely way and according to need.
• Systems and processes had been improved to enable the provider to effectively assess, monitor and improve the quality and safety of the services provided.
• The governance arrangements had been strengthened and covered permanent and temporary staff 24 hours a day, seven days a week.

The area where the provider should make improvements are:

• Refresh training for staff on the use of smartcards when using the computer system.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice