Archived: DHU 111 - Johnson Building

This service is rated as Outstanding overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at The Johnson Building, Locomotive Way, Derby between 11 March and 2 August 2019 as part of our scheduled inspection programme. The Johnson Building is one of three NHS111 call centres operated by DHU 111 (East Midlands) C.I.C. The other call centres were located at Fosse House, Leicester and Ashgate Manor, Chesterfield.

As Johnson Building was the primary centre and housed the managerial and administrative functions, Fosse House and Ashgate Manor were incorporated into one inspection under the title of Johnson Building.

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 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.
• Patients were able to access care and advice from the service within an appropriate timescale for their needs.
• Performance had been consistently higher than other similar services.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The service innovated to improve patient outcomes and to benefit the wider health care community and stakeholders.
• There was an effective governance structure with clear lines of responsibility.
• Staff expressed positive feedback about working in the call centres and their employers concern for their well-being.

We saw areas of outstanding practice including:

• The provider had collaborated with the commissioners to ensure that special patient notes had clear and easy to read instructions that helped ensure that health advisors got the patient to the right outcome within their own individualised and care pathway.
• The introduction of interactive voice recognition allowed for appropriate types of calls to be streamed via the telephony to the Service Advisor team. This in turn increased the capacity for Health Advisors to deal with more detailed assessments.
• The provider understood the needs of its population and tailored services in response to those needs. The service had introduced an Interactive Voice Response patient menu. This enabled patients and others calling the service to direct their calls more specifically using menu options relevant to their need. This enabled them to receive the most efficient and timeliest intervention. The options included dental, repeat prescriptions, new or worsening symptoms and care plans for end of life patients. Additionally, there were three silent options for ambulance crew on scene, care homes and health care professionals.
• Data from the Minimum Data Sets showed DHU NHS111 consistently performed better than other NHS111 providers and had done so over a period of time.
• The provider had placed a strong emphasis on staff health and well-being. They had put into a place a suite of measures to support their  staff’s own physical and mental health. This included flu vaccinations at the place of work, physical health checks, health promotion advice, additional support for staff following difficult or distressing calls and free, rapid access to counselling and psychotherapy.
• The provider had recognised that 76% of the workforce was female. In the last year DHU had worked to change the composition of the Senior and Executive Team to make it more balanced and moving forwards they aimed to continue to create a culture that encouraged equal representation in senior positions.
• The provider had introduced the NHS111 Career Framework which provided career progression such as Senior Health Advisor and Senior Clinical Advisor. These were seen as the foundations for careers in management roles.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care