Cambridge and Peterborough IUC Services

Updated 24 June 2022

The integrated NHS 111 and out-of-hours service for Cambridge and Peterborough is provided by HUC (formally known as Herts Urgent Care).

HUC is a Social Enterprise; a not for profit organisation with no shareholders and where any surpluses are re-invested into the service. The headquarters for HUC is in Welwyn Garden City, Hertfordshire.

Cambridge and Peterborough IUC Services operates NHS 111, out-of-hours and a variety of other services including primary care centres in other areas. Cambridge and Peterborough IUC Services commenced delivery of the integrated NHS 111 and out-of-hours service for Cambridge and Peterborough in November 2016.

NHS111 is a 24 hours-a-day telephone and online service where patients are assessed, given advice or directed to a local service that most appropriately meets their needs. For example, their own GP, an out-of-hours GP service, walk-in centre, urgent care centre, community nurse, emergency dentist or emergency department. GP out-of-hours services provide care to patients who require medical attention outside of normal GP opening hours. Generally, out- of -hours service operates from 6.30pm until 8am Monday to Thursday, and 6.30pm Friday until 8am Monday and all public holidays. Patients access the out-of-hours service via NHS 111 where the information provided is assessed and triaged and patients receive an appropriate response based on their clinical needs. This can be in the form of a clinical telephone assessment, referral to the patient’s own GP, a home visit from a clinician or an appointment for the patient to attend an out-of-hours base. The service provides care to a population of approximately 1.1 million people residing in the area and is commissioned by Cambridge and Peterborough Clinical Commissioning Group.

The area has two acute NHS Trusts, one NHS mental health trust and 88 NHS GP practices.

The Cambridge and Peterborough IUC Services operates the NHS111 contact centre from the Peterborough City Care Centre. Out-of-hours services in Cambridge and Peterborough area are delivered from six primary care centres located in Peterborough, Ely, Cambridge, Doddington, Huntingdon and Wisbech. Not all these primary care centres are open every day during the out-of-hours period. As part of this inspection we visited Peterborough City Care Centre and the Out of Hours bases in Peterborough and Cambridge. The service is registered with the CQC to provide the regulated activities of Treatment of disease, disorder or injury, triage and medical advice provided remotely, Diagnostic and screening procedures.

Updated 24 June 2022

This service is rated as Good overall.

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 at Herts Urgent Care (HUC) out-of-hours and NHS111 service provided from the City Care Centre in Peterborough, Cambridgeshire on 10 May 2018.

The service was inspected in March 2017 and rated as good, with the service being rated as requires improvement for delivering effective out-of-hours services. We did not inspect the NHS111 service in the March 2017 inspection.

In November 2016, HUC obtained the integrated NHS111 and out-of-hours contract for the whole county of Cambridgeshire. HUC therefore provided both NHS111 and out-of-hours services for the whole of Cambridgeshire at the time of this inspection.

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 provider actively monitored any patient contact involving child protection and safeguarding adults.

• The provider had systems and arrangements for managing medicines, including medical gases, emergency medicines and equipment and vaccines, which helped to minimise risks. Controlled drug registers were not consistently maintained in line with best practice guidance and there was no process to monitor the use of computer prescription forms. A senior member of staff we spoke with was not aware of the national guidance on prescription security. Following our inspection the provider took action and developed electronic solutions for recording information relating to prescriptions.

• The provider organised and delivered services to meet patients’ needs. It took account of patient needs and preferences.

• 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.

• Some staff we spoke with explained that local leadership and guidance in the form of policies and procedures was not always as desired. Also, some staff felt guidance in the form of policies and procedures had been slow to be implemented. The provider explained that due to external circumstances, outside of the provider’s control, implementation of some systems, policies and procedures had taken longer than expected. The provider was in the process of trying to recruit a GP clinical lead and clinical workforce manager for the Cambridgeshire area.

• Performance did not always meet contractual targets but was in line with, or exceeded, national performance.

• There were arrangements and systems in place to support staff to respond to people with specific health care needs such as end of life care and those who had mental health needs.

We saw one area of outstanding practice:

• The provider had an option available for patients that dialled NHS111 because of a concern for their mental health wellbeing; they could be redirected to the local mental health service single point of contact without needing to speak to NHS111 staff first. This approach had been developed locally and was being considered in other areas of the country. The provider communicated with the mental health service on a regular basis and the direct access option was reviewed by the mental health service regularly, with any outcomes or learning shared between the two services.

The areas where the provider should make improvements are:

• Review the policy and process for managing Controlled Drugs.
• Continue to monitor electronic solutions for recording information relating to prescriptions.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice