Phoenix House

Updated 16 January 2023

The integrated NHS 111 and out-of-hours contract for South and Mid Essex is provided by Integrated Care 24 (IC24). IC24 is a social enterprise (a not for profit organisation) which holds various healthcare contracts across Kent, Sussex, Essex and Norfolk and Waveney. The headquarters for IC24 is in Ashford, Kent.

IC24 operates NHS 111, out-of-hours and a variety of other services including primary care centres in other areas. IC24 commenced delivery of the integrated NHS 111 and out-of-hours service for Mid and South Essex in July 2018.

NHS111 is a 24 hours-a-day telephone-based service where patients are assessed, given advice or directed to a local service that most appropriately meets their needs. For example, their own GP, an out-of-hours GP service, self-care, walk-in centre, urgent care centre, community nurse, community pharmacy, emergency dentist or emergency department. People can call the service 24 hours per day, 365 days a year. The NHS 111 service is staffed by a team of service advisors, health advisors and clinical advisors who are experienced nurses, advanced care practitioners, urgent care practitioners, pharmacists and general practitioners.

GP out-of-hours services provide care to patients who require medical attention outside of normal GP opening hours. Generally, out-of-hours services operate from 6.30pm until 8am Monday to Thursday, and 6.30pm Friday until 8am Monday and all public holidays. Patients access the out-of-hours service via NHS 111 where the information provided is assessed and triaged and patients receive an appropriate response based on their clinical needs. This can be in the form of a clinical telephone assessment, referral to the patient’s own GP, a home visit from a clinician or an appointment for the patient to attend an out-of-hours base.

IC24 in Mid and South Essex provides care to a population of 1.2million people residing in the area and is commissioned by the Mid and South Essex Integrated Care Board. The provider recorded an approximate average year to date of 32,000 111 calls per month to IC24 from the Mid and South Essex area. Of these calls 21,000 came into the clinical assessment service (CAS) for clinical triage, 3,553 were seen ‘face to face’, 2,850 had a home visit, 2,500 required an ambulance disposition and 3000 were referred to their own GP.

Phoenix House is the location responsible for the governance, managerial and administrative functions of the 111 and out-of-hours service. The NHS 111 contact centre operates from Ipswich. Care and treatment for the out-of-hours service are delivered from 9 out-of-hours primary care centres located in Basildon, Braintree, Brentwood, Broomfield, Canvey Island, Grays, Halstead, Maldon and Westcliff-on-Sea. Not all these primary care centres are opened every day during the out-of-hours period. As part of this inspection we visited Phoenix House, the contact centre in Ipswich and the primary care centres in Basildon, Chelmsford, Grays and Westcliff-on-Sea.

The service is registered with the CQC to provide the regulated activities of Diagnostic and screening procedures, Transport services, triage and medical advice provided remotely and Treatment of disease, disorder or injury.

Updated 16 January 2023

This practice 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

We carried out an announced comprehensive inspection of Phoenix House on 29 November, 1 December and 4 December 2022 as part of our inspection programme. The service had not been inspected before.

At this inspection we found:

• The provider had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The provider 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 involved and treated patients with compassion, kindness, dignity and respect.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Improvements were made to the quality of care as a result of complaints and concerns.
• Call handling performance and waiting times in the NHS111 and out-of-hours service had been sub-optimal for some time due to increased demand coupled with staff shortages. The provider had a credible plan to improve.
• The leadership, management and governance assured the delivery of high-quality care, and supported learning and innovation throughout the organisation.

The areas where the provider should make improvements are:

• Continue to improve their performance data to meet the Key Performance Indicators and National Quality Requirements.
• Continue to ensure all staff have received safeguarding training that is appropriate to their role.
• Seek feedback from the mental health team to evaluate patient uptake of that service.
• Continue to identify trends from the new system of reviewing patient surveys to improve patient satisfaction.
• Continue to engage and have visible leadership in all primary care centres.
• Continue to ensure patients are visible to staff in the waiting room at all primary care centres.
• Continue to engage and work with the providers who are responsible for the premises used by IC24, to appropriately maintain the premises.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services