Updated 20 June 2017
Shropshire Doctors Co-operative Limited, also known as Shropdoc, was formed in 1996, initially a as a GP co-operative to cover the Out of Hours (OOH) period for GPs and has grown to now include around 350 GP members, covering a population of approximately 600,000 patients from GP surgeries in Shropshire, Telford & Wrekin and Powys. The population density is low especially in Powys. We inspected the OOH service provided by Shropdoc.
Shropdoc has its administrative headquarters and call centre in Shrewsbury. In addition there are 10 primary care sites based in community hospitals spread across the area, six in England, four in Wales allowing for a GP or urgent care practitioner to reach a patient within one hour of travel. These primary care sites are at:
- Elizabeth House, Royal Shrewsbury Hospital
- Princess Royal Hospital, Telford
- Bridgnorth Community Hospital
- Ludlow Community Hospital
- Whitchurch Community Hospital
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (only operates at weekends)
The four Centres in Wales are at:
- Llanindrod Wells War Memorial Hospital
- Newtown Hospital
- War Memorial Hospital, Brecon
- Victoria Memorial Hospital, Welshpool
As part of the inspection, we visited the administration centre at Longbow, Shrewsbury and visited three of the primary care centres, Shrewsbury, Telford and Whitchurch. All of the centres have car parking available to patients and are well served by public transport links. The primary care centre facilities are all shared with the respective hospitals using them in-hours and Shropdoc using them between 6.30pm to 8.30am.
The co-operative is a ‘not for profit’ company whose main workload (approximately 45%) continues to be the provision of OOH services but now includes new types of work including a Shropshire community nurse service, a physiotherapy telephone triage service, an acute visiting service, an oncology helpline, lone worker monitoring, a GP extended access service, patient appointment booking, an in-hours GP surgery triage and an OOH helpline for Shropshire Council. In September 2016, Shropdoc agreed to run a GP practice of approximately 4,000 patients in Whitchurch after plans to find a private provider to run the service collapsed. The provision of these services is through a 24/7 operation employing over 280 staff members. Employees work on a range of contracts with contractual hours guaranteed from one shift per week to full time employment. All staff regardless of whether short or long term duration are subject to employment checks which comply with the NHS Employment Check standards and follow a formal induction. The breakdown of staff employed is:
- 64 urgent care practitioners, 27.5 whole time equivalent (WTE).
- 9 urgent care practitioner prescribers, 1.8 WTE.
- 11 agency nurses, 3.9 WTE.
- 1 pharmacist, 0.9 WTE.
- 64 call handlers, 25.5. WTE.
- 90 drivers/receptionists, 23.8 WTE.
- 48 administrative/managerial/clerical staff, 45 WTE.
The OOH service operates between 6pm and 8.30am on weekdays and 24 hours on weekends and bank holidays. There is a team of call handlers, administrators and urgent care practitioners at the administrative headquarters and can be accessed during the day between 8am and 8pm. These opening times mean that Shropdoc is open for 72% of the year. The urgent care centres are open all day on weekends and bank holidays.
The provider was inspected once before in March 2014 as part of a pilot for inspecting OOH providers using the new CQC methodology. No ratings were given following that inspection. The inspection found only one area of improvement relating to signage to enable patients to locate the service.