Updated 16 October 2018
As a response to some safety concerns raised with the Care Quality Commission, we undertook an unannounced inspection of ELM Alliance Limited, (Redcar Hospital, West Dyke Road, Redcar, TS10 4NW) on the evenings of 11 July 2017 and 12 July 2017. At that inspection we gave the provider an overall rating of ‘inadequate’. Further focussed inspections were undertaken in November 2017 and January 2018. At our January 2018 inspection, we were satisfied that some improvements had been made and the provider was given an overall rating of ‘requires improvement’. At that January 2018 inspection we identified a further two breaches of regulation. We issued a warning notice for one of those breaches; Regulation 18 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Staffing. This September 2018 inspection was a focussed follow-up inspection to assess the progress of actions against that warning notice.
ELM Alliance Limited is commissioned by South Tees Clinical Commissioning Group (CCG) to operate the extended hours GP service (with appointments during the evening and out of hours) across South Tees. ELM Alliance, a federation of all GP practices within South Tees CCG, took over the operation on 1 April 2017, offering care to around 300,000 patients. The service operates from 6pm until 8am every day. From 6pm until 9.30pm extended hours appointments are available at all four of the locations. At 9.30pm every evening the locations at North Ormesby and Brotton close. The Middlesbrough and Redcar locations continue to deliver services from 9.30pm until 8am every day, as the organisation operates as an out of hours service during these times. It offers urgent care appointments, as well as routine face-to-face and home visit appointments to patients who have been referred to it via their own GPs; or urgent care appointments by the NHS 111 service.
Park Surgery, Linthorpe Road, Middlesbrough TS1 3QY is one of four locations registered by ELM Alliance Limited to deliver the enhanced urgent care service across the South Tees area. Since the beginning of July 2018, ELM Alliance has ceased to deliver services from the Park Surgery location and has moved to Bluebell Medical Centre, TS5 8SB. The additional locations are at Redcar Primary Care Hospital, Hirsel Medical Practice in North Ormesby, TS3 6AL, and Brotton Hospital in Saltburn, TS12 2FF. The service also has a vehicle which is used to transport clinicians to home visits during the night. On the day of our September 2018 inspection we visited the Hirsel location, to look at administrative and organisation functions. We did not inspect the clinical areas of this location.
There are 113 staff members working for the provider, many of whom have a zero hours contract or annualised hours arrangement in place. These include 45 GPs, 25 advanced nurse practitioners, one emergency care practitioner, six treatment room nurses, ten health care assistants and 26 administrative staff. Locums are used on a regular basis, in addition to the contracted staff. Many staff carry out their duties from more than one of the registered locations.