You are here

Inspection Summary


Overall summary & rating

Good

Updated 24 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at GP Out of Hours Unit, Diana Princess of Wales Hospital on 26 January 2017. Overall the service is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
  • Risks to patients were assessed and well managed.
  • Patients’ care needs were assessed and delivered in a timely way according to need. The service performed well against the National Quality Requirements (performance standards).

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • There was a system in place that enabled staff access to patient records. The out of hours staff provided other services, for example the patient’s GP and local hospital, with information following contact with patients as was appropriate.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved patient experience.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider should make improvement is:

  • Ensure medicines used for home visits are available and checked regularly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 24 May 2017

The service is rated as good for providing safe services.

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
  • There was an effective system in place for recording, reporting and learning from significant events.
  • Lessons were shared to make sure action was taken to improve safety in the service.
  • When things went wrong patients were informed in keeping with the Duty of Candour. They were given an explanation based on facts, an apology if appropriate and, wherever possible, a summary of learning from the event. They were told about any actions to improve processes to prevent the same thing happening again.
  • The Out of Hours service had clearly defined and embedded system and processes in place to keep patients safe and safeguarded from abuse.
  • There were systems in place to support staff undertaking home visits. For example, chaperoning.
  • Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
  • Risks to patients were assessed and well managed.

Effective

Good

Updated 24 May 2017

The service is rated as good for providing effective services.

  • The service was consistently meeting National Quality Requirements (performance standards) for GP Out of Hours’ services to ensure patient needs were met in a timely way.
  • Data showed the service had consistently high performance against the National Quality Requirements (the minimum standards for all out of hours GP services) to help ensure patient needs were met in a timely way. For example, in August 2016, 100% of urgent cases had a face-to-face consultation within 20 minutes and 99% of non-urgent cases had a face-to-face consultation within 60 minutes.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Clinicians provided urgent care to walk-in patients based on current evidence based guidance.
  • Staff worked with other health care professionals to understand and meet the range and complexity of patients’ needs.

The service worked closely with patients’ own GPs and information was shared with the Out of Hours’ service.

Caring

Good

Updated 24 May 2017

The service is rated as good for providing caring services.

  • Data showed that patients rated the service similar to others in relation to the care they received.
  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.
  • Patients were kept informed with regard to their care and treatment throughout their visit to the out of hours.

Responsive

Good

Updated 24 May 2017

The service is rated as good for providing responsive services.

  • The provider undertook continuous engagement with patients to gather feedback and held patient and public involvement events to source suggestions for improvements. Changes were considered to the way it delivered services as a consequence of this feedback. Patient satisfaction, patient safety, friends and family test results were discussed.
  • The provider reviewed the needs of its local population and engaged with its commissioners to secure improvements to services where these were identified.
  • Patients said access was good and National Quality Requirements data showed patients were consistently seen in a timely manner.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • The service had systems in place to ensure patients received care and treatment in a timely way and according to the urgency of need.
  • Information about how to complain was available and easy to understand and evidence showed the service responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 24 May 2017

The service is rated as good for being well-led.

  • The service had a clear vision with quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
  • High standards were promoted and owned by all service staff and teams worked together across all roles.
  • Governance and performance management arrangements had been proactively reviewed and took account of current models of best service.
  • There was a high level of constructive engagement with staff and a high level of staff satisfaction.
  • The service gathered feedback from patients and stakeholders which influenced service development. For example the provider attended patient participation groups at local GP practices to increase awareness of the service and encourage feedback.
  • The provider was aware of and complied with the requirements of the duty of candour. The provider encouraged a culture of openness and honesty. The service had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken.