Site visits: urgent care services

Site visits give us an opportunity to talk to people using your services, your staff and other professionals, to find out about their experiences.

They allow us to observe how you deliver care and to review people’s records to see how their needs are managed, both within and between services.

An inspection of an urgent care, GP out-of-hours or NHS 111 service usually lasts for one day.

Where services are managed from one location across multiple sites, we are likely to visit a number of the sites during a comprehensive inspection.

Gathering evidence during the site visit

To structure the site visit, the inspection team refers to the key lines of enquiry (KLOEs) in the assessment framework for healthcare services. They also look at any concerns identified beforehand through our monitoring activity. This enables them to focus on specific areas of concern or potential areas of outstanding practice. They collect evidence against the KLOEs using a variety of methods.

People who use services

We will gather the views of your patients, their family and carers, by:

• speaking with them individually
• using information from complaints and concerns sent through our website.

If we include an Expert by Experience on an inspection, they will talk to people at the premises on the day of the inspection.

Your staff

On all inspections, we are likely to speak to the following members of staff:

• members of your management team
• GPs and other members of the clinical team
• drivers
• call handlers
• administrative staff, including receptionists

For larger providers, the inspection team may also hold focus groups with separate groups of staff.

Gathering information in other ways

We may also gather information by:

• tracking a patient’s journey through their care pathway
• reviewing records
• reviewing operational policies and supporting documents

The start of the visit

At the start of each inspection the inspector will meet with a member of your management team. Where they are unavailable, the inspector can meet with your senior manager or a senior clinician. This short introductory session will introduce the inspection team and explain:

• the scope and purpose of the inspection, including the powers we have
• the plan for the day
• how we will escalate any concerns that we identify during the inspection
• how we will communicate our findings.

We want you to be open and share your views with us about where you are providing good care, and what you are doing to improve in areas that you know are not so good.

If we find that you have not been open with us about issues of concern that you already know about, this will emphasised and reflected when we assess the well-led key question.

The inspection team will review the emerging findings together at least once during the inspection. This keeps the team up-to-date with all issues and allows them to shift the focus of the inspection if they identify new areas of concern. It also enables the team to identify which further evidence they might need in relation to a line of enquiry and what relevant facts might still be needed to corroborate a judgement.

Feedback on the visit

At the end of the inspection visit, the lead inspector will meet with your senior manager to provide feedback. This is high-level initial feedback only, illustrated with some examples.

At the meeting, the inspector will:

• thank you for your support and contribution and tell you about any issues that were escalated during the visit or that require immediate action
• tell you if we need additional evidence or if we need to seek further specialist advice in order to make a judgement
• tell you about any plans for follow-up or additional visits (unless they are unannounced)
• explain how we will make judgements against the regulations
• explain the next steps, including how we process the draft inspection report
• answer any questions from the service

We will need to carry out further analysis of the evidence before we can reach final judgements on all the issues and award ratings.