Archived: Central Middlesex Hospital Urgent Treatment Centre

Updated 16 July 2019

Central Middlesex Hospital Urgent Treatment Centre serves the Brent and surrounding areas in North West London. The service is located at the Central Middlesex Hospital. There is no ‘accident and emergency’ service at the hospital, therefore the service works with other acute NHS trusts when patients require transfer to other emergency departments or specialist care.

Central Middlesex Hospital Urgent Treatment Centre is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury.

The urgent treatment centre is open 24 hours a day, seven days a week including public holidays. Patients can attend on a walk-in basis, self-present or they may be referred to the service, for example by the NHS 111 or their own GP. The local ambulance service London Ambulance Service (LAS) transports some patients directly into the urgent treatment  centre.

All patients are assessed through a process known as ‘streaming’ on entry by Emergency Nurse Practitioners. Patients with minor illnesses or minor injuries are streamed into the urgent care centre and more seriously unwell patients are streamed and sent off to the nearest the A&E departments. Clinical staff can also refer patients directly to other specialties within the trust and other hospitals, alternatively patients may be directed to another service if appropriate, such as the patient’s own GP. The clinical staff streaming patients work with the patient champion to redirect patients whose needs are not urgent, for example to, GP practices, pharmacies or dentists.

The urgent treatment centre is led by a service manager and a lead GP who has oversight of the urgent treatment centre. The urgent treatment centre is staffed by GPs, Emergency Nurses/ Care Practitioners (ENPS and ECPs) Lead Nurse as well as service manager and Lead GP. The service has access to a large number of internal bank staff provided by Greenbrook when needed. Greenbrook Healthcare operates a centralised governance system. The provider’s medical director and central team provide additional clinical and managerial support and oversight.

Updated 16 July 2019

We carried out an announced inspection at Central Middlesex Hospital Urgent Treatment Centre on 25 April 2019 as part of our inspection programme. This was the services first inspection since  registering with the Care Quality Commission.

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

At this inspection we found:

• The urgent treatment centre had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
• The urgent treatment centre routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff had the skills, knowledge and experience to deliver effective care.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• The provider took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• Leaders had the capacity and skills to deliver high-quality, sustainable care.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw an area of outstanding practice

• The service had developed a quite therapeutic room in which patients with special needs such as autistic spectrum could be seen from.

The areas where the provider should make improvements are:

• Continue efforts to configure the streaming room to improve visibility in the waiting area.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care.