Practice Plus Group - Devon 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.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

This service scored 75 (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.

If timeframes for call backs or home visits by clinicians were not going to be met, a patient safety call would be carried out. This was to ensure that the person’s condition had not worsened and to advise them of the delay. If their condition had worsened then a reassessment of need was carried out and the person was directed to a different service if needed, for example an appointment made with the out of hours GP. The Devon Clinical Assessment Service and out of hours service was able to utilise additional support from remote clinical staff working for Practice Plus Group for telephone/video consultations.

The service had a system that alerted staff to any specific safety or clinical needs of a person using the service. Clinicians were able to access peoples’ summary care records which gave a high-level summary of peoples’ needs and special notes related to particular needs such as end-of-life care, known allergies and medicines they were prescribed, with access appropriately restricted from health coordinators.

The provider improved services where possible in response to unmet needs. We saw several examples: Clinicians were able to access an online system - Pathways Clinical Consultation Support (PaCCs) to search services available to support people, including booking ambulances, in hours GP and clinic appointments for immediate and follow up. The service had a system that alerted staff to any specific safety or clinical needs of a person using the service.

Clinicians were able to add comments to peoples’ records, which operations managers followed up with in hours GPs to ensure concerns were actioned. Care followed national pathways for people with specific needs, for example those at the end of their life, babies, children and young people.

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.

The provider was aware of the geographical challenges in Devon and certain areas where unmet needs during day-time hours led to greater demand during the evening, overnight and at weekends. There was a fleet of 10 hybrid cars, used as a mobile resource in addition to face-to-face appointments offered at bases. Senior managers told us that cars were based at all eight Primary Care Centres across Devon. People triaged as having clinical needs and/or vulnerable and requiring home assessment were seen in their homes. We met home visiting GPs and drivers during the inspection all of whom had in depth knowledge of the county, the shortest routes and time it might take them to arrive at the person’s home. We saw people were given an estimated time, and their postcode was checked before the drivers left the centre.

The service was responsive to the needs of people in vulnerable circumstances. Clinicians accessed additional support for people from an urgent care response team (8am to 8pm), for example to collect a urine sample for analysis so treatment could be started. The community nursing team were also requested to carry out an initial assessment of people who were housebound, as a backup whilst waiting for a home visit by a GP

The service engaged with local primary care networks, support groups for people with learning disabilities, carers association and Healthwatch to understand and work with these agencies in providing care and treatment on a local level.

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

The service had access to interpreter services. If this is required, a flag was placed onto the record to inform the clinician or anyone else accessing the record that a translator is required.

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 provider’s policy and NHS guidance. Learning from complaints was evident and staff were able to identify changes made as a result of people’s feedback, including complaints.

Information about how to make a complaint or raise concerns was available and it was easy to do. Staff treated people who made complaints compassionately.

Between November 2024 and October 2025, the out of hours service received 69 complaints. The service had manged 86857 cases during that period, which equates to 0.07% of cases resulting in a complaint.

Through a monthly review of all complaints, themes were identified. These reviews were undertaken by the Patient Safety Manager and the Quality and Patient Experience Manager. Identified themes were discussed at weekly Quality meetings and the monthly Quality Assurance Meeting, where actions were agreed and discussed as to whether the theme poses potential risk. For example, when delays in home visits were identified as a risk, the service had implemented home visiting Paramedic roles to complement existing home visit provision. Regular rota meetings at a local level were undertaken to identify pinch points and target resource planning, with the workforce planning teams.

During the same period of November 2024 to October 2025, 37 compliments were received about the out of hours service.

Information from surveys showed:

Family and Friends test Summary - September 2025

• Good experience increased by 5.7% since August, reaching 89.7%.
• Poor experience decreased by 6.7% since August, now at 4.4%.
• Total surveys sent: 2613; surveys received: 307 (11.7% response rate).

Positive comments included one where a person had completed an online NHS 111 consultation, which resulted in a clinical callback being required within 2 hours. The person was contacted within 20 minutes by the NHS 111 service. The outcome reached was that they would need to be seen by an out of hours GP. The person was contacted 10 minutes after the call from NHS 111 and was provided with an appointment at a base within 30 minutes. The person was satisfied with the speed and ease with the process.

The service reviewed survey comments on a monthly basis to capture themes and shared positive feedback with staff. Negative comments from reviews aligned to known concerns such as wait times for appointments and these were being addressed through the overall risk register and action plan the service had developed, which was monitored on a monthly basis.

The service made sure that people could access the care, support and treatment they needed when they needed it.

People were able to access care and treatment at times that suited their needs. The provider operated a flexible model across its locations, ensuring comprehensive out-of-hours coverage including evenings, weekends, and bank holidays, tailored to the specific operational hours and demands of each individual site.

People could access the out of hours service via NHS 111. The service was not commissioned to see walk-in people. However, the provider had a policy should any person arrive and needed to be seen without having first made an appointment. For example people were told to call NHS 111 or referred onwards if they needed urgent care. All staff were aware of the policy and understood their role with regards to it, including ensuring that patient safety was a priority.

We reviewed the local key performance indicator results for July 2025 to September 2025.

◦ The percentage of patients receiving an urgent face to face consultation within 2 hours at a primary care centre ranged from 75.1% to 82.7%. The performance target was set to 80% or above.

◦ The percentage of patients receiving a routine face to face consultation within 6 hours at a primary care centre ranged from 86.3% to 91.9%. The performance target was set to 80% or above.

◦ The percentage of patients receiving an urgent face to face home visit within 2 hours ranged from 46.7% to 85.5%. The performance target was set to 80% or above.

◦ The percentage of patients receiving a routine face to face home visit within 6 hours ranged from 54.9% to 74.4%. The performance target was set to 80% or above.

Where the service was not meeting the targets, the provider was aware of these areas, and action plans were in place to address areas where performance was low. This was shared with local commissioners on a regular basis.

The service engaged with people who were in vulnerable circumstances and took actions to remove barriers when people found it hard to access or use services, for example, providing additional verbal contact and offering paper copies of surveys.

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.

Staff treated people equally and without discrimination. 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.

Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation.

The service worked with end of life clinicians in the community and hospices to support people who were receiving end of life care. Treatment escalation plans were available for clinicians to view and provide treatment in accordance with a person’s wishes. Clinicians working for the service were provided with training to enable them to have sensitive conversations with people receiving end of life care.