Northwick Park Hospital Urgent Care Centre

Updated 31 August 2022

Northwick Park Hospital Urgent Care Centre is a registered location that consists of three urgent treatment centres (UTC), one at Northwick Park hospital, Central Middlesex hospital, and Ealing hospital. The service provides urgent and emergency care for patients across a number of boroughs in North-West London

The service utilizes a hub and spoke approach. The main location is at Northwick Park hospital, Watford Road, Harrow, HA1 3UJ. The first of two satellites is at Central Middlesex Hospital, Acton Lane, London, NW10 7NS. The second satellite site is at Ealing hospital, Uxbridge Road, Southall, London UB1 3HW.

All three services provide treatment of minor injuries and illnesses, and provide a streaming service in order that patients are transferred to the right service either within the UTC or elsewhere. At Ealing and Northwick Park Hospitals, the streaming service is also the first point of contact for patients attending the emergency department which are co-located with the urgent treatment centre. Central Middlesex hospital does not have an emergency department. Ealing hospital emergency department and UTC does not manage paediatric patients.

The service is delivered by Greenbrook Healthcare (Hounslow) Ltd (Greenbrook). Greenbrook is a wholly owned subsidiary of Totally PLC, and currently manages 10 Urgent Care Centres in North West London, South East London and Watford. The organisation also manages another Urgent Treatment Centre on behalf of Vocare, which is another wholly owned subsidiary of Totally PLC.

The urgent treatment centres at Northwick Park and Ealing Hospitals are open 24 hours a day. The service at Central Middlesex Hospital is open from 8am until midnight, seven days per week. They are all an NHS service for patients who walk-in, or are referred by the NHS 111 service. Greenbrook provides doctors, nurses and streaming staff to the services, as well administrative staff. Streaming staff consist mostly of advanced and emergency nurse practitioners. Some of the staff who work at the service are employed directly by Greenbrook. However, most of the clinical staff and some of the administrative staff at the service are either bank staff (those who are retained on a list by the provider) or agency staff.

In the last year, the services have a combined attendance of between 16-22,000 patients per month. Approximately half of the patients seen by the services are at the Northwick Park site.

CQC registered the provider to carry out the following regulated services at the service:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures
• Transport services, triage and medical advice provided remotely

The service’s website address is http://www.greenbrook.nhs.uk.

Updated 31 August 2022

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

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 Northwick Park Hospital Urgent Care Centre on 2, 3 and 9 August 2022. The service had previously been inspected in October 2018 where it had been rated as good overall, and in all five key questions.

The registered manager is the Head of Quality and Governance at the location. 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.

Our key findings were:

• The service 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 service was not meeting targets for streaming patients as required by its commissioners. In particular, streaming times at the Northwick Park site were outside of levels defined as safe by national targets.
• 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.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the service easy to access and reported that they were able to access care when they needed it. However, the service was not ensuring a throughput of patients in line with its four-hour target.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure that care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Improve throughput times such that it meets targets for discharging patients in four hours.
• Review how to improve the lack of compatibility between the UTC and Emergency Department computer systems.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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