Archived: Arun House

Updated 23 March 2017

Staffordshire Doctors Urgent Care Limited (SDUC) is a limited company commissioned to provide the NHS 111 service to the population of Staffordshire. In North Staffordshire, SDUC also provides the GP out-of-hours service but the service contracts are not integrated. We will report on the GP out-of-hours service separately. The NHS 111 service covers a population of approximately 857,000 people living in Staffordshire. SDUC is part of the Vocare Group, a provider of urgent care services across the UK that includes GP out of hours services, urgent care centres and the NHS 111 service.

Vocare started providing the 111 service through SDUC in September 2014 on a short term contract. In October 2015, they were awarded a four year contract. SDUC operates two NHS 111 call centres in Staffordshire under a hub and spoke model. Staffordshire House in Stoke on Trent is the hub and Arun House in Stafford is the spoke site. These call centres are registered as locations with the CQC. Calls may be answered at either of the call centres, based on the availability of call advisors. We visited Staffordshire House during the course of the inspection. From April 2015 to March 2016 the service had received a daily average of 561 calls from patients and other seeking assistance. The daily call volumes averaged 458 on weekdays and 900 per day at weekends. The volume was projected to increase by 5% during 2016/17.

The workforce consists of four full time equivalent (FTE) management staff, seven FTE team leaders, two FTE governance staff, 62 FTE call advisors and 31 FTE clinical advisors. The senior management team consists of a Head of Region who reports into a Group Operations Director.

Patients ring the NHS 111 service where their medical need is assessed by a call handler or a clinical advisor based on the symptoms they report when they call. If a patient needs to speak to a doctor, the request is transferred to another service, for example, to the patient’s GP surgery, to the GP Out-of-Hours service or to the accident and emergency (A&E) department.

Updated 23 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of the Staffordshire Doctors Urgent Care NHS 111 service at Staffordshire House and Elizabeth House on 16 June 2016. NHS 111 is a telephone-based service where callers are assessed, given advice and directed to a local service that most appropriately meets their needs. For example, this could be a GP service (in or out of hours), walk-in centre or urgent care centre, community nurse, emergency dentist, emergency department, emergency ambulance, late opening pharmacy or home management.Overall the provider is rated as good.

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Staff knew how to and understood the need to raise concerns and report incidents and near misses. All events recorded were reviewed and categorised by the head of assurance for the Vocare Group.
• The provider was monitored against the Minimum Data Set (MDS) and Key Performance Indicators (KPIs). The data enabled the provider and commissioners to review the level of service being provided. Where variations in performance were identified, the reasons for this were reviewed and action plans implemented to improve the service.
• Staff were trained and monitored to ensure they used the NHS Pathways system safely and effectively.
• Information about services and how to complain was available and easy to understand. Complaints were fully investigated and when appropriate, patients were responded to with an apology and full explanation.
• There was clear leadership from a clinical and senior management perspective. Staff felt supported by senior management and a management rota was in place to ensure presence at busy times.
• There were safeguarding systems in place for both children and adults at risk of harm or abuse as well as frequent callers to the service. Safeguarding concerns were raised to the local safeguarding board but there was no evidence of any follow up from the provider.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• The provider had set clear priorities and strategies to achieve them. These included integration with the out of hour’s service and innovation to improve patient care.

However there were areas of practice where the provider should make improvements:

• Review the safeguarding procedures to consider if a follow up to referrals and concerns should be implemented.
• Ensure that standard operating procedures (SOPs) are reviewed and updated where necessary in line with the review dates on the documents and that outdated SOPs are removed.

Professor Steve Field CBE FRCP FFPH FRCGP