Archived: Royal Lancaster Infirmary Also known as Bay Urgent Care

Updated 5 February 2015

North Lancashire Doctors Limited is also known as Bay Urgent Care (BUC). BUC is registered to provide regulated activities from two locations based within the Lancashire local authority area, the Royal Lancaster Infirmary (RLI) and the Queen Victoria Centre (QVC). It provides Out of Hours (OOH) urgent care to temporary or permanent residents of Lancaster, Morecambe, Carnforth and the surrounding area. They provide care to approximately 140,000 patients per year.

43% of BUC OOH’s patients are from five GP practices in Morecambe. A population of 1,171,339 is recorded in the 2011 Census for Lancashire, with 97.1 % registered with a GP. There is a higher proportion of people aged 50 years and older and a lower proportion of 20-39 year old people living in Lancashire in comparison to the national average. 7.7% of people living in Lancashire are from ethnic minorities.

Calls to the service are handled by Fylde Coast Medical Services (FCMS) via the 111 telephone service that uses the NHS pathways assessment tool. It uses NHS pathways to support decision making for assessing patients, with clinical decisions centred on evidence based knowledge and clinical guidelines for best practice. BUC operates a triage model where all patients have clinical telephone assessments. This prevents unnecessary journeys for patients and enables appropriate coordination of home visits and appointments according to clinical urgency and demand.

GPs from local practices provide the service and respond in the same way as requests for home visits during normal daytime surgery hours. Patients can be seen in person by attending one of the services two locations.  

Staffs are employed to work for North Lancashire Doctors Limited and can work from either of the two registered locations. Registered nurses work a variety of hours at the RLI BUC many having set working days and some flexibility to offer additional hours when required. The GP clinical hours required to cover RLI BUC equate to 41 hours per week. The clinical team consisted of both male and female GPs from the local community. The team are supported by an administration / call handling team, receptionists, drivers and a management team who are responsible for the day to day running of the service. There is a stable clinical staff team who work for BUC regularly. The majority of the BUC OOH GPs are GP trainers.  

The RLI BUC location is open from 7pm to 10pm for patient appointments each weekday evening and from 9am to 9pm on Saturday and Sunday. However, access to the BUC OOH service is available to all patients from 6.30pm to 8am Monday to Thursday and 24 hrs Saturday, Sunday and Bank Holidays from their other registered location. During weekday day time hours the RLI BUC location operates as a hospital outpatient department. In the OOH period RLI BUC is staffed by a receptionist and either an Advanced Nurse Practitioner or a GP.

Updated 5 February 2015

Letter from the Chief Inspector of General Practice

We inspected Royal Lancaster Infirmary Bay Urgent Care on the 28 October 2014.

We inspected this service as part of our new focused, comprehensive, inspection programme. This service location had not been inspected before. We looked at how well they provided services and found the overall rating for this service was good.

Our key findings were as follows:

•           We found there were comprehensive governance and risk management policies, procedures and measures in place.

•           Patients told us they were treated promptly, could make appointments with ease following a telephone consultation, they were involved in care and treatment decisions and that all staff treated them with dignity and respect.

•           The service took time to listen to the views of their patients and produced a monthly patient satisfaction report, collating views from patients who had used the service. Where actions where required these were implemented and used to improve the service.

•           The service was working with a local hospice to provide care during out of hours periods and participated in the ‘Better care together’ agenda with the local Clinical Commissioning Group.

•           The service supported the implementation and roll out of a Prime Minister’s Challenge Fund Pilot entitled Opening Doors – Aligning and Integrating Health and Care Services in Morecambe (Lancashire). Five practices in Morecambe offer an 8am to 8pm seven days a week service for 61,000 patients.

•           The service provided staff with opportunities to express their views and set up the staff Morale -0 –meter surveys.

However, there were also areas of practice where the provider needs to make improvements. 

In addition the provider should:

• The provider had not ensured the serial numbers of all prescription pads both hand written and electronic, at the Royal Lancaster Infirmary location were recorded.

• Staff were overdue their annual appraisals.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice