We carried out a review of the data available to us about Practice Plus Group - East of England on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Practice Plus Group - East of England, you can give feedback on this service.
We carried out an announced comprehensive inspection at Care UK – East of England on 28 February 2017. The service provides out-of-hours GP and dental services. Overall the service is rated as good.
Our key findings across all the areas we inspected were as follows:
We saw several areas of outstanding service:
Chief Inspector of General Practice
We carried out a comprehensive inspection of the Care UK East of England NHS 111 service for Suffolk, Lincolnshire and Milton Keynes on 20 and 21 July 2016. The service operates from a single call centre in Ipswich but can also be operated from two other Care UK call centres at Southall (London) and Bristol.
NHS 111 is a telephone-based service where callers were assessed, given advice and directed to a local service that most appropriately met their needs. For example, this could be a GP service (in or out of hours), walk-in centre or urgent care centre, community nurse, emergency dentist, emergency department, emergency ambulance, late opening pharmacy or home management.
Overall the service is rated as ‘Good’.
Our key findings were as follows:
type of healthcare environment.
The areas where the provider should make improvement are:
The provider should ensure that all complaints are dealt with in a consistent way, ensuring all dates were recorded.
Chief Inspector of General Practice
Harmoni HS Ltd was founded in September 1996 by two doctors as a GP co-operative in Harrow. As of November 2012, Harmoni is a wholly owned subsidiary of Care UK with the core business being the delivery of out of hours care and NHS 111 services. Harmoni employs more than 1,700 clinical and non-clinical staff members.
The location inspected was based in the Suffolk local authority area and is registered to provide two of the six regulated activities which are: transport services, triage and medical advice provided remotely and treatment of disease, disorder or injury. The Harmoni – Suffolk out-of-hours base location reports to the NHS Ipswich and East Suffolk Clinical Commissioning Group (CCG).
The central administration and coordinating centre has eight satellite locations which provide services to people in and around the Ipswich area. The main base location is also the call handling and triage centre for National Health Service (NHS) 111 telephone calls across the Suffolk region. We visited the main central base in Ipswich where patients are not seen, and two other locations where patients attended for consultation and treatments. The two other locations visited were at Bury St Edmunds and Ipswich Hospital NHS Trust. Three of the remaining six location do not all open during the week on a regular daily basis and are opened on an ad hoc basis when required to provide a service.
The provider was chosen as part of the new wave inspection programme project and the visit was announced. The team was made up of five specialist advisors and a compliance inspector and the visit was conducted whilst the provider was working operationally.
During our inspection we spoke with six patients who were using the out-of-hours emergency GP service, and approximately 20 members of staff. Staff members included the regional medical director, director of operations / registered manager, doctors, lead nurse and operational staff such as call handlers and drivers.
The provider had satisfactory governance systems in place to protect patients from the risk of abuse and ensure that they received the appropriate safe emergency care and treatment. Medicines kept on the premises were stored appropriately and securely and staff received the training in the safeguarding of children and adults.
We found that the service had systems in place to ensure that the provider could effectively respond to the needs of the patients accessing the out-of-hours service safely. The provider monitored the call handlers to ensure that information was recorded and used effectively to prioritise patients appropriately according to how urgently they required care. Information regarding the care received by patients was shared with the people’s usual GP in a timely manner to ensure continuity of care between the different service providers.
Patients received a caring service. Patients told us that they were happy with the care they received and that they were involved in the decisions about their care. We were told that staff were polite and respectful and we observed this to be the case. There was opportunity for people to provide feedback as Care Quality Commission questionnaires had been made available in the waiting area prior to our visit. The provider also carried out regular satisfaction surveys to capture people’s views. The provider had a strategy in place for capturing the views of the GPs and ethnic minority groups within the area. There was easy access to the locations we visited with car parking availability at both sites.
The service was responsive to patients’ needs. Staff had access to the appropriate equipment, training and support. Although there was an expectation that medical staff would provide some of their own equipment. The provider carried out the appropriate employment checks on new and temporary staff to ensure that they were able and safe to carry out their roles.
The organisation was well led. There was a clear governance structure in place and a process for disseminating information to all members of staff. There was a complaints policy and procedure in place as well as a process for escalating incidents to senior managers by the duty coordinators. All complaints and incidents are reviewed through the Clinical Governance Committee. Staff told us that they felt supported and that the service was well-led. There were regular team meetings to ensure that information was cascaded to all staff team members; this included learning from incidents and any changes to practice across the organisation as well as locally.
The inspection did not highlight any non-compliance with the current Health & Social Care Act (2008) regulations.
On the 15 April 2013 we carried out a follow up inspection to make sure that the action plan we had been provided with was implemented. We found that there were now enough qualified, skilled and experienced staff to meet people's needs. We also found that all staff now received appropriate professional development.
When demand was extremely high escalation and contingency plans had been put in place. One staff member we spoke with told us, 'It can be very busy in the evenings and at weekends but I'm never sitting there thinking I can't cope.'
Arrangements were in place for the recording, handling storage and administration of medication. The correct checks were undertaken before staff began work. There were effective recruitment and selection processes in place.
There were not always enough qualified, skilled and experienced staff to meet people's needs but there were plans to address this. Most clinical staff were up to date with mandatory and statutory training but some medical staff had not received their training as planned. A staff member we spoke with told us 'They've been very good with training ' they regularly advertise other opportunities and events.'
There was evidence that learning from incidents and investigations took place and changes were being implemented.
One person we spoke with told us, 'I found the system very helpful ' they were able to tell me as well where I would find a pharmacy open and where to go if I needed more help.'