Archived: Co-Located Primary Care Service at St James's University Hospital

Updated 1 January 2019

The Co-located Primary Care Service at St James’s University Hospital was set up as a result of the provider being approached by local commissioners to provide a GP streaming service in the Accident and Emergency (A&E) department within the hospital. This was to help reduce pressure on urgent care systems and ensure patients were seen by the most appropriate clinician. As a result of its success, the service was formally commissioned by Leeds Clinical Commissioning Group (CCG) in October 2017.

The service operates seven days a week (including public holidays) from 11am to 11pm. There are five GPs (male and female) who cover 80% of the sessions (these are employed as sessional GPs by the provider). There are arrangements for locum GPs, or clinicians employed by the provider, to cover the remaining 20% of sessions. There is a clinical services manager who oversees the day-to-day operation of the service. They are supported by the Associate Director of Operations & Performance, who has extensive experience in urgent care and is also the Registered Manager of the service. In addition, they have access to personnel from a range of departments at provider level. For example, human resources and patient safety.

Patients cannot directly access the service. Using a set of protocols, patients who attend the A&E department, and may be more appropriate to be seen by a GP, are streamed to the service. Any patients who are streamed inappropriately, such as minor injuries, are referred back to the A&E department to be treated. Children under the age of 18 years are not seen at this service. (The A&E Department who treats children in Leeds is based at Leeds General Infirmary.)

The service located at St James’s University Hospital, Beckett Street, Leeds LS9 7TF is registered with the Care Quality Commission (CQC) to provide the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury
• Family planning
• Maternity and midwifery services
• Surgical procedures

The service is one of 11 registered services managed and operated by One Medicare Ltd (the provider). These include urgent care centres, GP practices and walk-in services. The provider’s head office and operations centre is based near Otley in West Yorkshire.

The service has not previously been inspected by the CQC.

Updated 1 January 2019

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 the Co-located Primary Care Service at St James’s University Hospital on the 13 November 2018. This inspection was planned and undertaken as part of our inspection programme and as part of a wider inspection of the provider (One Medicare Ltd). The provider had agreed to contribute to our Primary Care at Scale project.

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 treatment from the service within an appropriate timescale for their needs. The service was performing in line with service level agreements.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Staff said they felt supported by managers and leaders from both a local and organisational level.
• There was evidence of good engagement with other organisations and services relating to the provision of urgent care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice