NHS Urgent Care Centre

Updated 13 February 2017

The Urgent Care Centre in Nottingham opened in October 2015 and provides care to the population of Nottingham City and county areas. It is commissioned by the Nottingham City Commissioning Group (CCG). The centre was commissioned to provide care to 75000 patients annually and is currently averaging 60000 patients a year. The service is operated by Nottingham CityCare which is a community health service provider. They provide a range of community services in the Nottinghamshire area.

The Urgent Care Centre has been purpose built to ensure efficient treatment in a light and spacious environment and further consultation rooms have been added to meet patient demand as well as a larger reception and dedicated children’s waiting area.

The centre provides assessment and treatment for urgent health conditions such as: minor burns and scalds and skin infections to suspected broken bones, sprains and strains. The centre has x-ray services on site and is staffed primarily by health care assistants, nurses, advanced nurse practitioners and doctors. The clinical team are supported receptionists and a management and administrative team.

There is parking outside the centre including dedicated disabled spaces and the main railway station is nearby; all care is provided on a ground floor of a shared building.

The centre is open between 7am and 9pm 365 days a year and no appointment is required. The service operates from:

Seaton House

City Link

Nottinghamshire

NG24LA

Updated 13 February 2017

Nottingham Urgent Care Centre was previously inspected on 12 May 2016 in response to concerns. We found that the service provided at the centre was not meeting legal requirements and we set two requirement notices in relation to:

• Regulation 17 HSCA (RA) Regulations 2014 good governance, as the provider did not have effective systems in place to monitor and manage risk by having sufficient cover to enable staff to triage and see patients in a timely manner.

• Regulation 18 HSCA (RA) Regulations 2014 Staffing, as the provider did not have effective oversight of staffing requirements in order to deploy sufficient numbers to meet demand and have a systematic approach to determine the correct number of staff and range of skills to meet patients’ needs.

We carried out an announced, comprehensive inspection on 28 November 2016 and we also followed up on the requirement notices, considering whether sufficient improvements had been made. This inspection took place as part of a provider wide inspection of Nottingham CityCare by our Hospitals team.

The provider had addressed the concerns raised at the previous inspection. Overall the provider is rated as good following this inspection.

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

• There was a clear leadership structure and the vision of the service had been established. Staff we spoke to were aware of the vision and told us recent workshops to develop rotas and future strategy had improved the relationship between management and staff and created a more supportive environment in which to work.

• The management team had taken steps to improve communication with staff by holding morning huddles. There was an open and transparent approach to safety and an effective system in place to support the reporting, recording and investigation of incidents.

• The centre had taken steps to ensure there was adequate clinical cover by increasing the number of staff on shift to meet patient demand. This had been achieved through increased use of agency cover in the short term and the recruitment of further clinicians for long term sustainability.

• Following the recent refurbishment and expansion of the centre, consultation and treatment capacity had increased and there were good facilities equipped to treat patients in a clean and safe environment.
• We saw evidence that there had been a steady improvement in the assessment time of patients following the inspection in May 2106. However, the provider had still not been able to meet the targets set by the clinical commissioning group (CCG). At the initial inspection 30% of patients were not assessed within the agreed 30 minutes of arrival, this had reduced to 13% of patients over the previous quarter and plans were in place to improve this further.

We also saw an area of outstanding practice:

• The medical director had developed an application which allowed staff to review an anonymised patient record, reflect on the notes and automatically produced a scoring system to highlight areas of good practice. This provided clinical staff with an effective way to self and peer review their decision making, treatment plans and record keeping.

This application had been introduced over the last six months and had been utilised voluntarily 42 times by staff (by some staff multiple times) and the final scoring could also be used in appraisals, for development and good practice was celebrated.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice