Chorley Integrated Urgent Care Centre

Updated 8 January 2018

Chorley Integrated Urgent Care Centre (CIUCC) is located in the Chorley and South Ribble Hospital at Preston Road, Preston, Lancashire at PR7 1PP, adjacent to the hospital accident and emergency (A&E) department.

The service provides a fully integrated service including all aspects of urgent primary care, provided 24 hours a day, seven days a week. The service integrates out-of-hours care, an urgent care centre, a deep vein thrombosis pathway service and a pathway alternative to transfer (PAT) service. (The PAT service allows for the North West Ambulance service to refer patients to CIUCC who they had assessed as not being suitable for hospital attendance, in order to provide advice or treatment to patients in the most appropriate setting).

The service is provided by GO To DOC Limited, also known as gtd healthcare, a not-for-profit organisation contracted by NHS Chorley and South Ribble clinical commissioning group (CCG). GO To DOC also provide a similar integrated service from the Royal Preston Hospital. All services in Chorley started in November 2016 except for the urgent care service which started in January 2017.

The service is located in rooms leased on the ground floor of the Chorley and South Ribble Hospital. It comprises modern, purpose-built triage and treatment rooms, patient waiting areas, reception desks and a reception office. The service utilises the hospital car parking for patients with the first 30 minutes free; parking after that is pay and display. The waiting areas in the service are large, and there is suitable seating for patients; there are arrangements for children to wait in a separate waiting room which is brightly furnished and well-equipped. The waiting areas are shared with the hospital A&E department.

According to the Public Health England health profile for Chorley published on the 4 July 2017, the health of people in Chorley is generally similar to the England average. Chorley is on average a less deprived district in England and about 14% (2,655) of children live in low income families compared to the national average of 20%. The life expectancy for men is similar to the national average and for women, slightly worse.

The service is GP-led employing both salaried and sessional GPs. Staff at Chorley are also made up of advanced care practitioners, urgent care practitioners, registered nurses, healthcare assistants, drivers and care-co-ordinators. Some staff are shared with the service at the Royal Preston Hospital location. They are assisted by the GO To DOC management and administration teams based in Denton, Greater Manchester. Both clinical and non-clinical staff have lead roles in the organisation.

Updated 8 January 2018

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? – Outstanding

We carried out an announced comprehensive inspection at Chorley Integrated Urgent Care Centre on 14 November 2017. This was our first inspection of this new service.

At this inspection we found:

• The service had comprehensive 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 and frequently 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 told us that they appreciated the service and praised the staff who cared for them.
• Patients were generally able to access care and treatment from the service within an appropriate timescale for their needs. Where this was problematic, the service was working to an action plan to produce improvements.
• The patient engagement manager worked proactively with patients who contacted the service frequently to address their needs and reduce the number of times that they needed to contact the service.
• The service focused on the needs of patients. Managers told us that patients’ needs were central to the organisation.
• There was a proactive approach to managing the skill mix of staff needed to provide best care to patients. Staff felt respected, valued and supported.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. The organisation was forward thinking and had initiated schemes to improve outcomes for patients in the area. It was working with the hospital emergency department to agree pathways of care for different patient conditions.

We saw two areas of outstanding practice:

• Patients’ individual needs and preferences were central to the planning and delivery of the service. For example, the service had worked with deaf expert patients to help understand the needs of those patients following a patient complaint. They designed their own patient leaflets to explain the services that they offered and to give patients health information.
• The service leadership offered all staff a chance every year to bid for innovations that would benefit the organisation or the local community. We saw evidence of where this fund had been invested over the three years previously and staff told us how much they appreciated being consulted regarding the service and community development.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice