Walsall Urgent Treatment Centre

Updated 22 August 2022

Walsall Urgent Treatment Centre (UTC) is located in the Walsall area of the West Midlands and situated within Manor hospital which is part of Walsall Healthcare NHS Trust. The local area has a diverse population with high levels of deprivation. The service is accessible by major bus routes and car parking is available outside the main building.

The service is commissioned by NHS Black Country Integrated Care Board (ICB) which is part of the Black Country Integrated Care System (ICS). The service is delivered based on an integrated approach to urgent health care, which includes out of hours, urgent care and walk-in services delivered from the one location. The out of hours service is delivered by Malling Health Sandwell Out of Hours (OOH) Service. This is a separate service registered with the Care Quality Commission (CQC) by the provider organisation Malling Health (UK) Limited.

Malling Health (UK) Limited was established in 2009, and currently has a number of services across England delivering NHS primary care. This includes, Urgent Treatment Centres (UTCs), GP and out of hours services. The head office is based in Manchester and comprises of a small team who operate areas such as human resources, IT and quality functions. There is a senior leadership team, a quality governance board and a clinical governance framework outlining accountability of quality and safety at regional and national level.

The service is open from 7am to midnight seven days a week including bank holidays and is designed and equipped to manage a range of minor injuries and illnesses which are not critical or life threatening. A pod located near to the Emergency Department (ED) of Manor Hospital provides a front door streaming service by a Registered Nurse (RN) for patients presenting in ED. The purpose of the streaming service is to direct people to the most appropriate care based on their clinical symptoms and risk prioritisation. This may result in admission to ED or an assessment at the Urgent Treatment Centre (UTC). The service has recently been commissioned to provide a wound care service to support GP practices within Walsall.

People can access the service by various routes such as self-presentation as a walk in, referral by their registered GP or if advised by NHS 111. People may also be directed to the service by the streaming nurse located in the ED or by a referral from an ED clinician. In some cases, people may be referred from the ambulance service following strict safety protocols and a handover between the UTC clinician and the paramedic.

There are approximately 30 staff directly employed by the service who work various hours in substantive posts. The team consists of GPs, Advanced Nurse Practitioners (ANPs), Registered Nurses (RNs), Health Care Assistants (HCAs) and administrative staff. The staffing levels are supplemented based on capacity and demand modelling. There is a regular team of GPs and ANPs working on a self-employed basis including portfolio GPs (an umbrella term used to describe any GP who has multiple roles within their working week) or contracted by an agency.

The local management team consists of the Operational & Quality Lead (also the CQC registered manager), Assistant Operational Manager, lead nurse and team leader who are supported by the Regional Director of Operations and Clinical Chair.

The service is registered by the provider with the CQC as an urgent care service. The following regulated activities can be carried on at or from the location Walsall Urgent Treatment Centre:

• Transport services, triage and medical advice provided remotely

• Treatment of disease, disorder or injury

• Diagnostic and screening procedures

• Family planning

• Maternity and midwifery services

• Surgical procedures

Updated 22 August 2022

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

We carried out an announced comprehensive inspection at Walsall Urgent Treatment Centre (UTC) in response to concerns and complaints we had received about the service. This included areas linked to triaging, long waiting times, lack of communication and the suitability of the facilities and premises. The service had not been inspected since registering with Care Quality Commission (CQC).

At this inspection we found:

• The service had good 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.
• 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 treated people with compassion, kindness, dignity and respect.
• Patients were overall able to access care and treatment from the service within an appropriate timescale for their needs. Surges in demand for the service in addition to ongoing pressures in the system meant delays were unavoidable but minimised as much as possible. Patients were triaged and prioritised based on risk. The service continued to review and respond to pressures on the service.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Staff described a positive culture with learning encouraged and supported.
• There was compassionate, inclusive and effective leadership.

The areas where the provider should make improvements are:

• Review the recruitment policy to ensure clarity and consistency in documents requested as part of the recruitment process.
• Consider developing the providers website to make information about individual services more accessible to patients.
• Continue to review capacity and demand to improve patients experience of the service.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Our inspection team was led by a CQC lead inspector. The team included a GP specialist adviser.