Archived: Hampshire Doctors On Call

Updated 16 March 2017

The GP Out of Hours service for Hampshire including Southampton and Portsmouth since our last inspection is now provided by Partnering Health limited; previously under the name of Portsmouth Health Limited. When the name of the provider changed there was no change in legal entity for the Care Quality Commission.

Partnering Health Limited currently provides two services: the Out of Hours service for Hampshire and an NHS Primary Care walk-in centre and GP Practice in the centre of Portsmouth. This inspection report refers to the inspection of the Out of Hours service registered as Hampshire Doctors on Call Service.

Hampshire Doctors On Call service was launched on 15 April 2015 with more than 100 employees from the previous service provider who transferred via TUPE arrangements into the new service (TUPE is the Transfer of Undertakings Protection of Employment Regulations 1981, implemented to protect employment rights when employees transfer from one business to another).

The service is commissioned by five Hampshire Clinical Commissioning Groups (CCG’s):

• Fareham and Gosport CCG

• Portsmouth CCG

• South Eastern Hampshire CCG

• Southampton City CCG

• West Hampshire CCG

The Partnering Health Limited contract is with, West Hampshire CCG, Portsmouth and South East Hampshire CCG and Southampton CCG. Partnering Health Ltd currently manage the service for all the listed CCG’s on an individual basis but work collaboratively regarding contract management and delivery of service.

Hampshire is a county on the southern coast of England, bordered by Dorset, Wiltshire, Berkshire, Surrey and West Sussex. Data shows an increasing population, specifically the over 65 year old population has increased by 21% between 2001 and 2011; nearly double the national increase of 11%. This has increased pressure on health and social care provisions in the region. A total of 95.5% of the population are registered with a GP and there are a lower than average proportion of Black and Minority Ethnic residents in Hampshire.

The Out of Hours service provides care to patients who require urgent medical care from GPs and nurses outside of normal GP hours. Currently 347 members of staff including GPs (150 as self-employed GPs), nurses, drivers and support staff work for the service delivering care to patients.

The service operates county wide from 6.30pm until 8am Monday to Thursday, and 6.30pm Friday until 8am Monday, and all public holidays. Hampshire Doctors on Call Service does not offer walk-in appointments; access to the service is via the national NHS 111 call line. In Hampshire this is a service provided by the South Central Ambulance Service (SCAS) from their base at Otterbourne near Winchester.

The service provides care to a population of approximately 1.76 million (2011 census) residing in the area and operates from 10 primary care centres geographically spread across the county. The 10 primary care centres are:

• Andover Hospital, Andover SP10 3LB

• Chase Hospital, Bordon GU35 0YZ

• Cowplain Health Space, Waterlooville PO8 8DL

• Gosport War Memorial Hospital, Gosport PO12 3PW

• Lymington Hospital, Lymington SO41 8QD

• Queen Alexandra Hospital, Portsmouth PO6 3LY

• Ringwood Medical Centre, Ringwood BH24 1JY

• Royal Hampshire County Hospital, Winchester SO22 5DG

• Royal South Hampshire Hospital, Southampton SO14 0YG

• Totton Health Centre, Totton SO40 3ZN

At the time of our inspection a new registered manager application was being made by the service.

Hampshire Doctors on Call Service is registered to provide three regulated activities: diagnostic and screening procedures, transport services, triage and medical advice provided remotely and treatment of disease, disorder and injury.

The main primary care centre is based within Royal South Hampshire Hospital, Southampton SO14 0YG and is the registered location with Care Quality Commission. Members of our inspection team visited this primary care centre on 29 September 2016 and Queen Alexandra Hospital, Portsmouth PO6 3LY on 30 September 2016.

Updated 16 March 2017

Letter from the Chief Inspector of General Practice

We carried out a focused inspection of Hampshire Doctors On Call to check that action had been taken since our previous inspection in November 2015. Overall the practice is rated as good.

At our previous inspection, the service was rated good for Effective, Caring, Responsive and Well Led services and was rated as good overall. However, the practice was rated as requires improvement in the Safe domain due to breaches of regulations relating to the safe delivery of services.

This was because:

• Non-clinical staff who acted as a chaperone had not received appropriate training and the policy did not reflect the role and purpose. Staff members acting as a chaperone did not have a risk assessment or a criminal records check via the disclosure and barring service (DBS). Where the decision had been made not to carry out a DBS check on staff, the service was unable to give a clear rationale as to why the check had not been carried out.

• Relevant staff had not received all mandatory training including safeguarding children and basic life support.

We inspected the service on 29 and 30 September 2016 to confirm that they now met legal requirements.

You can read the last published report from our last comprehensive inspection of Hampshire Doctors on Call on our website at www.cqc.org.uk

Our key findings for this inspection were as follows:

• The provider had been working with the five local clinical commissioning groups to discuss how to improve and maintain response times for patients accessing the service.
• There was an open, transparent approach and a system in place for reporting and recording significant events.
• The provider had introduced a programme of mandatory training modules for members of staff and was working through the programme. We saw that emails had been sent out from management to members of staff reminding them to complete the modules and a matrix was provided showing that 90% of the courses had been completed at the time of our inspection.
• Relevant staff had received chaperone training and the provider carried out Disclosure and Barring Service checks for employees who may be asked to carry out the role of a chaperone. The chaperone policy had been reviewed and subsequently staff were issued with an aide memoir of the role. The provider had a continuing training programme for staff to become chaperones if they wanted to be. We saw patient information was available in the treatment sites we visited about chaperoning services.
• Disclosure and Barring Service checks for employees were now being carried out.
• The service had clearly defined processes and practices in place to keep people safe and safeguarded from abuse.
• The service was introducing a new staff appraisals policy and process however they were unable to produce evidence that appraisals were regularly taking place. The service had taken over the responsibility for the delivery of the contract in April 2015. This included more than140 self-employed GPs working in 10 sites and more than100 employees from the previous service provider transferring. Staff we spoke with told us that they had received an appraisal when working for the previous employer in 2015. We were told the staff appraisals were due to commence in late 2016.

The practice is now rated good for Safe services.

However there were areas where the service should be improved.

• The provider should improve on the delivery of plans for all staff employed to have an appraisal annually that is recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice