Archived: Hanover House

Updated 22 December 2020

Hanover House is the base hub for the 24-hour 111 service for South West London covering the boroughs of Wandsworth, Merton, Sutton, Kingston, Richmond and Croydon. The provider is Vocare who have responsibility for several 111, out of hours and urgent care services throughout the UK, and they have managed this service since September 2016. Vocare is a subsidiary company of Totally PLC. The service is co-located with the hub base for the out of hours service for four of the six boroughs, although this service is delivered by a separate provider. The service serves a population of over 1.5 million patients.

Although the main hub site is in London, services are provided from three addresses. The first is 78 Coombe Road, Kingston-Upon-Thames, Surrey, KT2 7AZ. Calls are no longer taken at this location, and it is now a hub for the service’s management staff. Further services are provided from a call centre at Medway House (formerly Crutes House), Fudan Way, Thornaby, Stockton-on-Tees, Cleveland, TS17 6EN, which manages 70% of all calls. The remainder of call are taken at Vocare House, Balliol Business Park, Benton Lane, Newcastle upon Tyne, NE12 8EW.

The service covers a large urban area, with large populations of both high and low deprivation. The population of South West London includes a large number of different nationalities and ethnicities.

Although the provider is headquartered in Newcastle where many senior staff are based, there are clinical and operational leads within regions who have overall responsibility for the delivery of the service. The operational teams are led by clinical support managers and team leaders in both the Stockton and Newcastle offices, each of whom have responsibility for a shift team.

Prior to 2020, the service managed between 27,000 and 32,000 calls per calendar month depending on the time of year. This is equivalent to approximately 1,000 calls per day. However, as a primary point of contact for calls relating to COVID 19, call volume had increased substantially during peak periods of infection during the pandemic. This had led to call demand at some stages in excess of 300% higher than normal levels during periods which have seen high infection rates.

The service is registered with the CQC to provide the regulated activity of Transport services, triage and medical advice provided remotely.

Updated 22 December 2020

This service is rated as Good overall. The service was previously inspected on 27 July 2017, for a second time on 5 and 6 July 2018 and most recently on 10 and 11 September 2019. At the most recent inspection the rating for the practice was requires improvement overall. This rating applied to the safe, effective, and well led key questions. Caring and responsive were rated as good.

The report stated where the service must make improvements:

• The service was not delivering service in line with standards defined by national quality requirements and other local and national guidelines.
• The service did not have systems in place to deliver sustained improvement.
• Staff told us that there were insufficient numbers of both health advisers and clinical call handlers at the service.

We carried out an announced comprehensive inspection at Hanover House on 11, 12, 13 and 16 November 2020. We are mindful of the impact of COVID-19 pandemic on our regulatory function. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. At this inspection we found that those areas which had previously been in breach of CQC regulations had been addressed

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect. The organisation met with patient representative groups with a view to improving its service.
• Patients were able to access care and treatment from the service within timescales similar to that of other providers while operating with an increased demand on service during the COVID 19 pandemic.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• The provider should review their performance against minimum data set call answering criteria.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care