Harold Wood Urgent Treatment Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff provided patients with effective care and treatment and advice and support. Staff worked with other services to achieve this. At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good. This is because the service had made the necessary changes to improve.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The assessment of people’s health care and treatment needs was mostly effective.

Patients had an initial clinical assessment by a clinician within 15 minutes of registration. The assessment comprised of a brief history and basic observations. When required, full observations including ECGs and X-rays could be requested.

The service did not have the facilities to take patient bloods; we were told patients were sent to Queens Hospital if urgent or referred to their own GP.

Patients were directed to the most appropriate place for their clinical needs. For example, urgent care for Illness or injury, accident and emergency at a local hospital and external redirection, such as pharmacies, or their own GP.

When patients were directed to the UTC for minor injury or illness, they were told to wait in reception and wait for the clinician to call them. Staff had a direct line of sight to the reception, and when doctors/nurses collected patients, we were told they would carry out a visual check and record this.

Staff had community site streaming guidance to follow to ensure they were sent to the appropriate place.

We reviewed a sample of patient records and found all patients had the necessary observations and were directed to the appropriate place. Leaders explained there was a known issue in the clinical information system whereby it over calculated the paediatric early warning score. Staff were made aware of this in their training and manually calculated the early warning score when required. The issue has previously been raised with the clinical information system provider who were looking to resolve the issue.

Clinical staff undertook clinical consultations dependent upon their skill set. For example, urgent care practitioners did not see children under 5 years who had a possible bone fracture.

Patients who presented with mental health concerns, were referred to mental health services.

The service planned and delivered people’s care and treatment in line with legislation and current evidence-based good practice and standards.

All clinical staff had a regular review of their consultation records to ensure they were providing competent care and treatment. At the previous assessment we found the organisation was not up to date with clinical guardian audits at the site. (Clinical guardian audits were the routine review of patient clinical consultations to assess the quality of clinical practice against established standards.) At this assessment we found from April to June 2025 the service was up to date with the audits and had met their target of a review of 1% of the patient clinical consultations and achieved a review of 1.33% of all the patient consultations. Most of the reviews found the patient consultation records were found either good or satisfactory and with a few requiring reflection.

Staff had evidence-based protocols and clinical pathways to follow to support them to deliver care and treatment. The initial assessment team had a weekly focus group to discuss clinical learning.

The clinical lead was supported by a site clinical lead. The doctors had a clinical forum every 2 weeks, to help improve patient care and treatment.

The organisation completed medicines audits, and specific audits to the service being offered. Prescribing audits were led by the lead pharmacist and the findings of audits were shared with staff.

The service worked well across teams and services to support people. They shared their assessment of needs when people moved between different services.

Staff communicated promptly with patient’s registered GPs so that the GP was aware of the need for further action. An electronic record of all consultations was sent to patients’ own GPs. Staff also referred patients back to their own GP to ensure continuity of care, where necessary.

When patients were transferred to the local accident and emergency department a copy of the record of their initial assessment and a handover to the paramedics took place.

Patients were also referred to the local GP access appointment hubs and secondary care.

The service supported people to manage their health and wellbeing. The service supported people where possible to live healthier lives.

Where appropriate, staff gave people advice so they could self-care. Risk factors, where identified, were highlighted to patients and their usual care providers so additional support could be given. Where patients’ needs could not be met by the service, staff redirected them to the appropriate service for their needs.

The organisation had an effective system in place to routinely monitor people’s quality of care and treatment and to continuously improve it.

The quality and safety of the service was monitored by the quality and safety meeting and clinical audit and medicines management group, who reported to the integrated governance and audit committees, and in turn to the PELC council.

The organisation had a proposed clinical audit plan in place for 2025/26, this included paediatric clinical safety, safeguarding referrals, missed fractures, and medicine audits which was agreed by the committees. However, no national led audits were planned at the time of the assessment.

All clinical staff had a regular review of their consultation’s records; at the previous assessment we found the service was not up to date with clinical guardian audits at the site. At this assessment we found that this was up to date and was monitored by the combined clinical audit and medicines management group.

Performance was monitored daily to ensure they met the 15-minute initial assessment and 4-hour seen and discharged national targets.

The service obtained consent to care and treatment in line with legislation and guidance.

Clinicians understood the requirements of legislation and guidance when considering consent and decision making. Relevant staff had been provided with training in the Mental Capacity Act. Clinicians supported patients to make decisions. Where appropriate, they assessed and recorded a patient’s mental capacity to make a decision.