Practice Plus Group - South West London OOH/CAS

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

This is the first inspection for this service since its registration with CQC. This key question has been rated as good.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

We saw the service worked in partnership with other services, including people’s own GP to meet the needs of its service user population. The service had tailored its services to meet the diverse needs of its community. There were established mechanisms for engaging with GPs in the local area.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information to promote the take up of screening and immunisation programmes was available in a range of languages. The service had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints were managed in line with the service’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of service user feedback, including complaints.

The service made sure that people could access the care, support and treatment they needed when they needed it. However, the service was not meeting all targets set within their contract.

The CAS service received a high acuity of cases in its calls. The service, was providing a higher number of calls, and acuity of presentations than the service would be expected to provide. The service had implemented a thorough “comfort calling” service provided by CAS co-ordinators in order to ensure that people were kept up to date with when they could expect a clinical call.

The OOH service was also not meeting targets for people to be seen within specific times at the base hubs, with the exception of routine appointments which was being met. However, the service was offering the contracted number of appointments at these hubs. Home visits were also not meeting targets but were consistently over 60% for all 3 targets relevant to the service. The targets relate to the time in which the visit should be made given the urgency of the patient’s condition. The service was offering a consistently high number of appointments. Drivers and clinicians that we spoke to told us that traffic in London could make targets difficult to achieve, particularly 2-hour dispositions. They told us that this problem could be exacerbated during the evening due to higher traffic levels.

The provider told us that they were working with commissioners, and hoped to revise targets given contextual issues encountered by the service.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. For example, the service employed a patient engagement manager who met with a variety of community groups within all 6 boroughs to advertise the service provided. The service was able to show an increase in use of the service following these sessions. The sessions also shaped how the service would be delivered in the future.

Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service, as an urgent care provider, did not develop end of life care plans. However, the service did provide medicines support to people receiving palliative care.