Archived: Viaduct Care CIC

We carried out an announced, comprehensive inspection at the Viaduct Care community interest company (CIC) GP Federation on 16 December 2019. This was the first inspection of this extended hours service. Our inspection included a visit to the service’s headquarters, its reception and treatment rooms and to one of the eight hub sites where the service operated.

Viaduct Care GP Federation provides extended access appointments with GPs for patients of all practices within the Stockport clinical commissioning group (CCG) during evenings and weekends. The provider also works closely with the CCG to produce and help practices deliver a quality improvement programme aimed at improving the health of the local population. The service provides pharmacy, well-being, acute home visits and first line physiotherapy services in addition to GP services. GP Extended hours are from 6.30pm to 8pm weekdays, 8 am to 1pm at weekends and treatment room extended hours 9am to 5pm at weekends at the providers base.

The chief executive officer (CEO) is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

As part of our inspection, 12 people provided feedback about the service via CQC comment cards and we spoke to a further four people who told us about their experiences using the service during the inspection visit. All of them were very positive about the service. Patients described the service as excellent and praised the staff and GPs for their caring and understanding attitude. They told us they found the service very convenient and the clinicians very professional.

Our key findings were :

• The service had comprehensive systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes. There was a blame free culture.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
• There was a strong focus on quality improvement. Audit was meaningful and informed by service outcomes.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs. Patient feedback on the service was consistently positive.
• Continuous learning and improvement were central to the organisation. Practice and patient needs were used to inform service development and were fundamental to the organisation aims and values. Staff were clear on how they contributed in providing high levels of patient care.
• Leaders had an inspiring, shared purpose, and strived to motivate staff to succeed. There was strong collaborative team working ethic and reliable support across all areas. Staff we spoke with told us how clear, inspiring and motivating the leadership team were. The leadership team had been quick and thorough in introducing new and responsive services to the people of Stockport.
• Staff at all levels were enthusiastic and demonstrated high levels of knowledge and professionalism.
• There was a common focus on improving the quality and sustainability of care.

We saw the following outstanding practice:

• All staff were highly engaged with the leadership team to provide the best outcomes and care possible, staff reported high levels of support and understanding of how to achieve this. Staff had been involved in developing their vision and values and feeding back on how the work they did achieved high standards of care.
• Staff at all levels of the organisation had spent time reflecting and documenting how they contributed and strived to exceed the health and social care regulations that applied to their service delivery.
• The provider had introduced quality champions for each of their identified quality standards; medicines management, medicines equipment, safeguarding, infection control, information governance, leadership, health and safety, case studies, clinical records, quality improvement and supervision.
• The provider worked with other stakeholders to positively contribute to the local healthcare economy and ensure patients receive the most appropriate care, therefore relieving pressures elsewhere in the system.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care