Archived: Rotherham Equitable Access

Updated 30 May 2017

Rotherham Equitable Access Centre is located at Rotherham Community Health Centre, Greasbrough Road, Rotherham S60 1RY and provides a nurse led walk-in service for 257,000 patients living in the Rotherham area. The service is provided by Care UK Clinical Services Limited.

The walk-in-centre is contracted by the local clinical commissioning group (CCG) to offer treatment, information and advice for a range of minor illnesses and injuries. Most patients walk in to access the service. Patients may be seen by an advanced nurse practitioner, paramedic, nurse or a GP depending on their needs.

The service employs a Medical Director, a General Manager, a Service Manager, a Service Lead, a Lead Nurse, administrative and reception staff, a triage nurse and advanced nurse practitioners.  The team are supported by a Regional Clinical Director. Managerial and administrative staff worked across this service and the out-of-hours service which was co-located in the same building. The service employed sessional GPs and temporary emergency care practitioners, advanced nurse practitioners and nurses directly and occasionally through an agency.   

The walk in service is open seven days a week (including bank holidays) from 8am to 9pm. The average number of patients seen a week is 889.

The service also provides a GP and receptionist who are based at the local accident and emergency department to see those patients with less urgent symptoms. In addition, the centre  provided the deep vein thrombosis assessment service for patients between the hours of 8am to 4pm.

Updated 30 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rotherham Equitable Access Centre on 22 and 23 March 2017. Overall the service is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
• Risks to patients were assessed and well managed.
• Patients’ care needs were assessed and delivered in a timely way according to need.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. 
• Following a pilot in collaboration with the local hospital trust and the primary care trust in 2011 a GP from the service was routinely rostered to work within the local emergency department during weekdays, evening and weekends. The emergency department staff would direct patients who could more appropriately be seen by the GP to them.
• With the patient's permission, there was a system in place that enabled staff access to patient records. Record of patients contact with the equitable access centre could be sent to the patient's own GP or other health provider.
• The service managed patients’ care and treatment in a timely way.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience. For example, the service provided a deep vein thrombosis (DVT) diagnostic service between 8am to 4pm on weekdays. Staff told us the service was popular with patients as they could be seen straight away, rather than attending the emergency department and if clinically indicated treatment commenced.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• A member of reception staff raised concerns with the GPs that a child was a frequent attender. In response,the service had implemented a frequent attender’s process for children aged under 12 years old. This meant the service collated information about frequent attenders at both the equitable access centre and the out-of-hours service and reviewed it to identify any possible safeguarding concerns. The staff brought any concerns to the patient's own GP's attention or to the local safeguarding board.

The area where the provider should make an improvement is:

• Review how the service measures the timings of patient consultations within the rapid assessment model to capture the patient consultation start and end time. 

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice