Louth County Hospital

Updated 10 July 2014

The GP out-of-hours service for Lincolnshire is provided by Lincolnshire Community Health Services NHS Trust. The service is commissioned by the four Lincolnshire Clinical Commissioning Groups (CCG’s), with the lead for out-of-hours services being Lincolnshire East CCG.

The out-of-hours service provides care to patients who require urgent medical care from a GP outside of normal GP hours.102 GP practices are covered by the service. The provider employs the services of 100 GPs who are engaged on a sessional basis to deliver care to patients. The service operates county wide from 6.30pm-8am Monday – Thursday, 6.30pm Friday – 8am Monday, and all public holidays.

Initial telephone contact with the out-of-hours service is through 111, a service provided by another healthcare provider.

The out-of-hours service is split into three ‘Business Units’, which comprise the North West, East and South business units. They are geographically aligned to Lincolnshire’s Clinical Commissioning Groups.  The out-of-hours service in each is managed by an Urgent Care Matron.

The service provides care to a population of 723,000 residing in an area of 2,350 square miles from eight primary care centres geographically spread across the county. The eight locations are;

The County Hospital, Lincoln                                      

John Coupland Community Hospital, Gainsborough  

Grantham and District Hospital                                    

Stamford and Rutland Hospital, Stamford                  

Johnson Community Hospital, Spalding                     

The Pilgrim Hospital, Boston                                      

Skegness and District Hospital                                    

County Hospital, Louth                                            

In the year 2013/14 in excess of 100,000 patients accessed the out-of-hours service. The Out-of – Hours service at County Hospital Louth is located adjacent to the Urgent Care Centre.

Updated 10 July 2014

Lincolnshire Community Health Services NHS Trust provided out-of-hours General Practitioner (GP) services for patients living in Lincolnshire. The service was administered from the trust’s headquarters in Sleaford and patient care and treatment was provided from eight primary care centres at locations across the county. We visited the trust’s headquarters on 5 June 2014 where we looked at records and information and talked with staff about issues that related to all eight locations and the service a whole. On the 6 or 7 June 2014 we visited the primary care centre at County Hospital Louth and spoke with members of staff, patients and carers and reviewed documents and matters specific to that location.’

The provider conducted clinical audit that addressed specific areas of patient care. Individual clinicians’ practice was assessed on a regular basis to help ensure that patients received safe and effective care and treatment.

We found the service was effective in meeting patients’ needs and the primary care centres were accessible to those who may have had a mobility issues.

We saw that leaflets to inform patients about how they might raise a complaint were only available in English but we saw documentary evidence that the Clinical Commissioning Group had instructed that they should not be printed in other languages due to cost.

There were systems in place to help ensure patient safety through learning from incidents and infection prevention and control.

Staff were trained and supported to help them recognise the signs of abuse of children and vulnerable adults and provided staff with training to heighten their awareness of domestic violence.

The provider had not used effective recruitment processes to assess the suitability of staff to work in this sector. We have told the provider they must improve.

Patients experienced care that was delivered by dedicated and caring staff. Patients and carers we spoke with said staff displayed a kind and caring attitude and we observed patients being treated with respect and kindness whilst their dignity and confidentiality was maintained.

The provider had in place business continuity and contingency plans that would enable the service to continue to operate in the event of a failure of, for example, the information technology or telecommunication systems.

We found that the service was well-led and managed by a knowledgeable senior management team and Board of Directors. They had taken action to help ensure their values and behaviours were shared by staff through regular engagement.

Members of the staff team we spoke with held positive views of management and their leadership and felt well supported in their roles. They told us the senior managers were approachable and listened to any concerns or suggestions they might have to improve the level of service provided to patients.

We found the provider did not have appropriate systems in place for safe storage, administration and recording of medicines. Following our visit the provider took steps to improve the medicines management systems to keep patients safe.   The provider had suitable arrangements to protect service users and others who may be at risk from the use of unsafe equipment. Systems were not in place to ensure equipment was properly maintained and suitable for its purpose. Staff did not always implement these systems