Bracknell Urgent Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective - This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence.

At our last assessment, we rated this key question Requires Improvement. At this assessment, the rating has changed to Good.

During our assessment of this key question, we found relevant staff and teams were involved in assessing, planning and delivering people’s care and treatment. Staff worked collaboratively to understand and meet the range and complexity of people’s needs. The service used evidence-based clinical decision assessment tools and during our review of a sample of medical records, we identified care and treatment was provided in line with national guidelines. Staff were proactively supported and encouraged to acquire new skills and share best practice. We saw examples of outstanding practice, the service had a comprehensive audit program to review and improve outcomes for patients. For example, there were well developed links with other service providers and organisations to support care and treatment to improve patient outcomes through local minor injury referral pathways, Virtual Fracture Clinics. The service provided accessible information and partnered with a local school with children who had additional communication needs, implementing information packs to aid patient journeys and educate children on the service.

This service scored 79 (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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

During our inspection, we reviewed a randomised sample of clinical records and found patients had an adequate record of medical history with thorough clinical notes detailing their care, treatment, safety netting and referral pathways if necessary.

On arrival at the service, all minor injury walk-in patients received an initial assessment performed by the Triage Clinician. In the pre-booked minor illness appointments, the initial assessment was carried out during the consultation in the patient’s allocated slot, as the patient was already triaged by the referring GP service.

The service performed triage within national guidelines measuring observations and applying risk stratification to determine further care and treatment. Staff were trained to assess and identify signs of deterioration in the patient’s condition, including escalation procedures such as transfer to local emergency departments.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. We reviewed a randomised sample of clinical records and found the service had carried out care and treatment in line with legislation and current evidence-based good practice and standards.

The service regularly reviewed the Directory of Service (DoS) with the local Integrated Care Board (ICB) to ensure patients were directed and referred to appropriate services from the Urgent Care Centre and via 111 and NHS Out of Hours services. Service leaders used Health Care Practitioner Feedback forms to raise any improvements and feedback about the management of a patient during these assessments.

The service worked well across teams and services to support people. Staff and leaders’ feedback demonstrated that patients were receiving good quality care. We were provided with evidence of patient feedback themes and trends supporting an effective and systematic approach to care. For example, the service worked with local healthcare services who supported the patient pathways and the onward referrals. Service leaders met with the wider One Medical Care team which produced monthly governance reports. The reports contained end to end reviews of patient care which included the review and changes to standard operating procedures for learning purposes. These were made available to staff through regular communications and local service meetings.

The continuing development of the staff’s skills, competence and knowledge was recognised as being integral to ensuring high-quality care for patients. For example, the provider demonstrated their core values of developing people. Staff had opportunities to learn and develop clinical skills through practical workshops, as well as through case study learning and continuous professional development opportunities. For example, the clinical service lead carried out audits of clinician’s care and treatment records and support clinicians with further competency checks such as prescribing in a mentorship capacity.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support. This included identifying those who need extra support, through a targeted and proactive approach to health promotion and prevention of ill-health, and they use every contact with people to do so.

The service met the accessible information standards. For example, a hearing loop was installed within the premises and there was access to interpreters and translation services. Easy read posters and leaflets were available to inform people about their treatment and worsening symptoms advice.

The service monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

People consistently received timely care and treatment, which was monitored by the service. Leaders were able to demonstrate patients were able to access and be seen by the service through performance reports. These contained triage, care and treatment and discharge timeframes, which were consistently meeting and surpassing commissioning standards. The service consistently carried out at least 95% of walk-in and 111 directed patients initial assessment within 15 minutes of arrival. We found at least 95% of people were seen, treated, referred and discharged within 4 hours as set out in monthly performance reports. These key performance indicators (KPI’s) were set out nationally by NHS England for urgent care providers and the provider consistently exceeded targets in these areas.

The service made significant improvements in the Virtual Fracture Clinic (VFC) referral pathway for minor injury patients. The service worked collaboratively with the local VFC sites, Royal Berkshire Hospital, Frimley Park Hospital and Wexham Park Hospital through monthly meetings. The service developed and implemented discharge policies that had a substantial positive impact in patient outcomes and the efficiency of services through a reduced number of unnecessary referrals. This had directly eased the pressure on these services, contributing to a more streamlined patient journey. Clinical leaders ensured all referred radiology reports were received and reviewed daily to improve the care and treatment follow-up outcomes for patients.

The service provided accessible information and partnered with a local school where many of the children had additional communication needs, often attending the centre accompanied by teachers, carers, or parents. The service identified a gap in the service related to effective communication with these children as interactions primarily occurred through an accompanying adult. As a result, the service implemented information packs such as in Makaton to aid patient journeys and educate children on the service. There were further plans to provide visual aids and storyboards so that children were familiar with the urgent care centre and what to expect on the patient journey. The service had plans to invite the communication Lead from the local school to deliver training sessions to service staff to equip staff with more effective practical skills.

The service informed people about their rights around consent and respected these when delivering person-centred care and treatment.

There were systems and processes in place to identify and record palliative patients or end of life patients to ensure they received appropriate care and treatment. The service had mental capacity assessment guidance and flowcharts available to ensure staff were able to follow the requirements set out in the Mental Capacity Act (2005). Staff were trained and had guidance to review and ensure specific care plans were identified for people whose resuscitation and emergency treatment wishes were known. The provider had access to annual training for staff in relation to the Mental Capacity Act, learning disabilities and consent.