LCW UCC (St Charles Centre for Health and Wellbeing) Also known as St Charles Centre for Health & Wellbeing

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of the NHS 111 service provided by the London Central & West Unscheduled Care Collaborative Limited on 2 and 3 March 2017 at its NHS 111 single site location at St Charles Hospital, London W10 6DZ. NHS 111 is a 24 hours a day telephone based service where people are assessed, given advice or directed to a local service that most appropriately meets their needs.

Our key findings were as follows:

The London Central & West Unscheduled Care Collaborative Limited (LCW UCC) NHS 111 service provided a safe, effective, caring, responsive and well-led service to a diverse population in West and North Central London. Overall the provider was rated as good.

• There was an open and transparent approach to safety and an effective system in place to report and record significant events. Staff knew how to raise concerns, understood the need to report incidents and considered the organisation a supportive culture. All opportunities for learning from internal incidents were discussed to support improvement. Information about safety was valued and used to promote learning and improvement.
• The provider maintained a risk register to identify and take preventative action and promote service resilience, and held regular internal and external governance meetings.
• Staff took action to safeguard patients and were aware of the process to make safeguarding referrals. Safeguarding systems and processes were in place to safeguard both children and adults at risk of harm or abuse, including calls from children and frequent callers to the service.
• The provider had a thorough recruitment and induction process in place for all staff to help ensure their suitability to work in this type of healthcare environment.
• The service was monitored against a National Minimum Data Set (MDS) and Key Performance Indicators (KPIs). These data collection tools provided intelligence to the provider and commissioners about the level of service being provided. Data provided showed the provider was meeting the majority of its targets. Action plans were implemented where variation in performance was identified.
• Staff had been trained and were monitored to ensure they used NHS Pathways safely and effectively (NHS Pathways is a licensed computer-based operating system that provides a suite of clinical assessments for triaging telephone calls from patients based on the symptoms they report when they call).
• Patients using the service were supported effectively during the telephone triage process and consent was sought. We observed staff treated patients with compassion and respect.
• The provider had been part of several collaborative pilots to improve care pathways and enhance access to care and treatment for patients.
• The provider was responsive and acted on patients’ complaints effectively and feedback was welcomed by the provider and used to improve the service.
• There was visible leadership with an emphasis on continuous improvement and development of the service. Staff felt supported by the management team.
• The provider was aware of, and complied with, the Duty of Candour. Staff told us there was a culture of openness and transparency.

There were areas where the provider should make improvements:

• Continue to address the challenges of recruiting substantive staff and the reliance on agency staff to ensure adequate numbers of skilled staff are available to provide a safe and effective service.
• Continue to monitor and manage through action plans National Minimum Data (MDS) and Key Performance Indicator (KPI) targets which fall below national targets.
• Ensure that all staff are aware of and understand the principles and responsibilities of the Duty of Candour.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice