Barking Urgent Treatment Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good due to improvements the service had made in response to the findings of the previous assessment, including staffing and clinical guardianship arrangements.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The organisation listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The organisation commenced implementing a new NHS incident reporting system, Patient Safety Incident Response Framework (PSIRF) in August 2024. Leaders met daily and weekly to review incidents reported that day and week, to promptly identify serious incidents and any immediate learning for implementation. This was additional to the governance team’s review and oversight of incidents.

Learning from incidents was shared with staff by emails across the staff rota system and a quality and safety bulletin issued monthly. The integrated governance committee report from July 2025 found the incident themes for Barking UTC were the initial assessment staff redirecting patients incorrectly and doctors’ arriving late to work. In response, the leaders had made amendments to the doctor’s contracts and reminded them about the necessity or arriving on time and provided further supervision and training for initial assessment staff.

The organisation had a system in place to manage the receipt and response to Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts. The response to the alerts was monitored through organisation’s sub-committees, and information was cascaded to staff through the quality and safety bulletins.

The service worked with patients and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Barking Urgent Treatment Centre was not co-located with an AE department, therefore most patients presented with lower acuity and risk. Patients who required emergency care were transferred using the 999-ambulance service to Queen's Hospital, King George Hospital or Newham Hospital. Information from PELC demonstrated that patients had a good understanding of the service provided, during the three months from April to June 2025, they had transferred 16 patients experiencing potentially serious conditions that required urgent transport.

Patients who attended the UTC registered at the reception area, once registered they had an initial clinical assessment (streaming) by a clinician within 15 minutes of registration. The assessment comprised of a brief history and observations, and x-rays may be requested. All patients were then directed to the most appropriate place for their clinical need. Patients directed to the UTC, were told to wait in reception and wait for the clinician to call them. Reception was monitored by the clinical staff to identify any patients who were deteriorating; staff signed a form each hour to demonstrate this had been carried out.

Patients who required blood tests were sent to Queens or King Georges Hospital or referred back to their GP.

Clinical staff had community site initial assessment/streaming guidance to follow, which included exclusion criteria.

The organisation’s staff worked closely with the North East London NHS Foundation Trust (NELFT) and Barking Hospital staff to improve services for patients. Staff said the relationships had improved to enable patients to be seen promptly.

The time for patients to wait before they were initially clinically assessed and treated was monitored by the operational managers to ensure targets were met. At the time of the assessment 99.7% of patients were seen within 15 minutes for their clinical assessment and 99.1% of patients were seen and discharged within 4 hours.

Patients who had special notes on their patient records, were flagged and prioritised, for example the elderly and people with a learning disability.

Where patients required a two week wait referral for urgent care and treatment by secondary care, this was monitored by the service to ensure they were seen promptly.

Safeguarding systems, processes and practices were developed, implemented and communicated to staff. There was active and appropriate engagement in local safeguarding processes.

Information demonstrated staff actively referred patients to the safeguarding teams when appropriate and recorded their actions. The staff always had access to a member of the leadership team for advice and support. The safeguarding lead reviewed the safeguarding referrals to provide advice and identify regular attendance, any themes and improvements monthly. All their findings were fed back to staff in the quality and safety newsletter; cases were discussed in staff supervisions. Most staff were trained to appropriate levels for their role.

The organisation and the local integrated care board met to discuss assurance issues relative to safeguarding.

Any children or adults deemed as vulnerable were prioritised and seen promptly.

In line with the local hospital, the organisation followed the operational pressure escalation levels, a framework used by the NHS to assess and manage operational pressures in healthcare settings.

Daily meetings were held to ensure that staff resources were sufficient. The recently appointed operational managers were onsite and dealt immediately with the staffing resources to ensure patients were seen within 15 minute and 4-hour targets. This had resulted in an improvement in meeting targets.

Patients who required urgent emergency care were transferred using the 999-ambulance service to Queen's Hospital, King George Hospital or Newham Hospital. Staff had a professional number they could call when an urgent ambulance was required to transfer patients to the local emergency departments and was for healthcare professionals to simplify/expedite the ambulance request process. Patients who were assessed as having non-urgent needs were asked to make their own way to the emergency department.

The service had accessible emergency equipment which was regularly reviewed and maintained by PELC staff.

Staff told us receptionists were taught and could identify signs of sepsis. In addition, sepsis information was displayed in the initial assessment room.

Staff monitored patients who reattended and would contact the patients GP if needed.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The service was located in Barking hospital who allocated the area of the premises and had the responsibility for the upkeep of the building.

The service had clear signage in the waiting room to direct patients to the appropriate areas and information about the current waiting times. During our visit the waiting area was busy, but seating was available, and reception staff told us there was always enough seats for patients. At the time of our visit the service did not have a specific waiting area for children.

The service-maintained equipment according to manufacturers' instructions.

The service had a security risk assessment in place.

The organisation had the necessary recruitment checks and induction for the different staff contracts and roles in the service, which included references and Disclosure and Barring Service (DBS) checks. We were told that clinical staff did not commence working at the service until they had carried out shifts at either Queens or King George Hospital.

All staff had to complete training to assess their competency during their induction.

The organisation had an effective system in place to monitor and ensure all staff completed the appropriate mandatory training. Information submitted by the provider demonstrated over 83% of staff had completed their mandatory training except for staff who were self-employed and worked in the minor injury unit. Directly employed clinical staff had access to a monthly focus learning group covering different health conditions.

At the previous assessment we found the organisation was not up to date with clinical guardian audits at the site. (Clinical guardian audits were the routine review of patient clinical consultations to assess the quality of clinical practice against established standards.) At this assessment we found from April to June 2025 the service was up to date with the audits and had met their target of a review of 1% of the patient clinical consultations and achieved a review of 1.33% of all the patient consultations. Most of the reviews found the patient consultation records were found either good or satisfactory and with a few requiring reflection.

The service had implemented a workforce planning document to determine the staffing requirements, and the managers met each morning to discuss staff cover for the service. Staff were allocated to most of the available hours on the rota. Where there was insufficient staff, this was raised as an incident. Leaders told us they had recruited a significant number of doctors and clinical streaming staff. The service was operated by a receptionist, initial clinical assessment staff, a GP, two minor injuries clinical staff and healthcare support worker. The operational managers told us patients would be redirected to other UTCs if the staff resources were insufficient.

A new system was in place for monitoring clinical supervision of directly employed staff (streamers). However, the supervisions were not always occurring three monthly as recommended in the organisation’s policy.

The staff who worked for NELFT were responsible for identifying and managing infection control risks. They detected and controlled the risk of infection and spreading and shared concerns with appropriate agencies promptly.

We visited the service and found appropriate standards of cleanliness and hygiene were being met. The organisations had leads for infection control, and they carried out regular infection prevention and controls audits of the premises and improvements were discussed and actioned. The leaders provided examples of staff learning across the organisation.

At a previous assessment, hand hygiene audits were not routinely conducted. At this assessment, regular hand wash audits were in place.

The cleaners followed daily cleaning schedules and staff carried out daily checks of the rooms they worked in.

The most recent Infection control audit report was completed 13/12/2024, where the service scored 100% for vaccine management 100% for clinical practice, clinical equipment,sharps management, and for waste. 94% for Hand Hygiene, 88% for governance, 77% for management for clinical environment and 43% for decontamination. The service had an action plan in place to ensure improvements were made.

Most of the organisation’s staff had completed infection prevention and control training with the exception of the staff who were self-employed and worked in the minor injury unit, where 75% of staff had completed their training.

Whilst clinical staff followed the Green Book immunisation guidance, the organisation had only recently begun implementing a system to ensure non-clinical staff also complied.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

The systems and arrangements for managing medicines, including medical gases, emergency medicines and equipment, and vaccines minimised risks. Medicines, including controlled drugs were ordered, recorded, stored and disposed in line with national guidance and legislation. Medicines were supplied via prescriptions, patient group directions (PGDs), and for patients to take away supplies.

Whilst most prescriptions were usually sent electronically via the electronic prescribing service (EPS), the EPS had been out of service since earlier in the year. The service managed supplies with paper FP10s prescriptions. There was a clear auditable process for the ordering, storing and distribution of the paper prescriptions. They were kept secure and accessible by only authorised staff.

Patient group directives (PGDs) used to supply medicines by non-prescribing clinicians were reviewed regularly. The organisation had recently worked with its partner organisation to develop new PGDs, to ensure consistency in the care people received. The new PGDs were not embedded at the time of the assessment. However, it was not clear from the PGDs for antibiotics if there had been appropriate specialist advice from a microbiologist when developing them.

The service had a pharmacy team who supported staff with managing medicines.

Staff had access to emergency medicines and these were regularly checked.

The service had previously had an issue the temperatures of rooms being too warm and possible affecting the medicines, in response they had procured a fridge which stored the medicines at the correct temperature.

The service had a system to audit and review staff’s consultation records each month. This review included ensuring that medicines were being supplied and recorded in line with national guidance and local policy.