Urgent Care Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

WELL-LED: Systems and processes to support good governance and oversight of risk had been implemented, developed and improved and the provider was working at pace to improve the culture of the workplace for all staff.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Since our previous inspection we saw that the provider had made improvements to their Freedom to speak up arrangements. The original guardian was still in place, but staff had been given the opportunity to volunteer as champions and were active in raising awareness of what this meant for staff, assuring them of the protection it would bring, and allowing staff to have their voices heard. One of the champions we spoke with was actively trying to raise the profile of the speaking up process and had plans to hold a coffee morning for staff to engage them in this area.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

FCMS NW Ltd is not responsible for the provision of front door assessments for walk in patients however there are regular senior management liaison meetings at least weekly. Managers informed us that despite a good working relationship, front door and other issues at the NHS Trust/FCMS interface continue to adversely affect patient flow and waiting times. Although aware of these, Doncaster Bassetlaw NHS Foundation Trust and FCMS have yet to develop standard operating procedures or memorandums of understanding to clarify and improve joint working practices. This means that any issues that arise must be resolved daily by individual clinicians and managers. For example; patient flow and timings at the front door, paediatric emergency department discharge working arrangements, direct access to Same Day Emergency Care facilities and specialities for clinicians working in the UTC.Patients were frequently re-routed to the emergency department after a clinical assessment in UTC adding unnecessarily to waiting times. Clinicians in the UTC informed us that this was because clinicians in SDEC, clinical specialities and the minor injury unit (MIU) were reluctant to accept patients directly from the UTC.

As well as impacting efficient patient flow, it was unclear at which point clinical responsibility passed from the NHS trust to FCMS NW Ltd. There was a risk posed of a patient deteriorating between departments and clinicians feeling it was another department’s clinical responsibility.

Since our last assessment FCMS NW Ltd had worked effectively to improve its governance and oversight of systems and operating procedures within its own department. Managers have listened to concerns raised by CQC in respect of the warning notices issued and have taken action to address those matters. Reporting and communication of risk and performance had improved. Staff had been given the opportunity to adopt lead roles which had improved oversight and created a more effective audit trail of information so that leaders and managers could hold people to account. Each staff group now had a clinical governance representative which strengthened oversight and collaborative team working.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.