Liverpool 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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. We assessed all quality statements from this key question. At our last assessment in November 2018, we rated this key question as requires improvement. At this assessment the rating has changed to good.

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 provider had effective tools in place to triage, prioritise and assess patients. The provider used nationally recognised tools to triage people with a range of presenting conditions, and safely identify clinical priority to ensure people with the most immediate needs were seen first. People were categorised for risk using a red, amber, yellow, green stratification and staff across the service could therefore readily identify those patients who were assessed as requiring more urgent attention. There was a process to determine when observations of people were to be repeated whilst they waited for a full assessment and treatment and to ensure any immediate care and treatment, such as pain relief or temporary dressings were given.

During times of increased pressure when demand exceeded staffing capacity the service stepped down to a triage only service to support and maintain people’s safety. The triage only service ensured that staff reviewed the patient’s condition, took their vital observations, assessed their clinical issue and provided some initial treatment if required. People who were assessed as acutely unwell or vulnerable continued to be prioritised for a comprehensive assessment following triage. If a person was a low priority for assessment and deemed safe to wait, they were either signposted to an alternative service or asked to return for an assessment the next day. These people were provided with any relevant patient information leaflets and informed what to do if their condition deteriorated.

The service used a nationally recognised scoring system NEWS2 (National Early Warning Score 2) to facilitate early identification of sepsis, and these patients were managed accordingly.

Staff reported all incidents when the service implemented the escalation process which allowed the leadership team to review the reasons for this and if possible, make changes to service provision.

The clinical team had access to people’s in-hours GP notes to assist with assessing needs. The UTC had established a collaborative working relationship with the local hospital and a number of other services to ensure people received appropriate care and treatment. Where people’s needs could not be met by the service, staff redirected them to the appropriate service for their needs.

The provider had systems to ensure staff were up to date with relevant legislation, evidence-based practice and required standards.Clinical staff had access to guidelines from the National Institute for Health and Care Excellence (NICE) and used this information to ensure that people’s needs were appropriately met. Audits took place to ensure guidance was adhered to, for example, audits of antibiotic prescribing and clinical record keeping. Our review of clinical records indicated that people received care, treatment and support that was evidence based and was in line with good practice standards.

The provider had a training and development programme in place that was tailored to different staff roles and responsibilities. A system of annual appraisal was in place. A trust wide process was in place for annual review of each nurse prescriber and monitoring of prescribing took place to ensure competence.

Leaders had a clear understanding of service performance against key performance indicators, they regularly discussed performance at senior management and board level.

Staff had timely access to the information they needed to assess, plan, and deliver care, treatment, and support effectively. When patients moved between services, relevant staff and teams coordinated assessments to ensure continuity of care. After each consultation, the service sent an electronic record to the patient’s GP, and staff communicated promptly to ensure GPs were informed of any required follow-up.

Leaders and staff collaborated closely with colleagues and stakeholders to respond to urgent needs and support the wider healthcare system. They prioritised care for clinically vulnerable patients and worked with other professionals to deliver appropriate treatment. For instance, when patients required emergency care, the local hospital’s Medical Emergency Team attended on-site to provide immediate support.

The provider had established formal referral protocols with NHS 111 for patients entering and exiting the service. The Urgent Treatment Centre (UTC) developed clear treatment and referral pathways and built strong links with local services, including the emergency department, paediatrics, orthopaedics, burns, ophthalmology, and mental health services. Staff could also refer patients directly to these services when needed.

The service supported people to live healthier lives and manage their health and wellbeing. People who used the service were referred or signposted to relevant services and local support services for care and treatment, information, education, advice and support linked to their needs.

Members of the clinical team provided people with information and support to manage their health, care and wellbeing where possible. People were provided with information to support them to make healthier choices, to promote and maintain their health and wellbeing and prevent deterioration.

The service identified people who may need extra support. Risk factors were identified and their normal care providers made aware so additional support could be given. Where people’s needs could not be met by the service, staff redirected them to the appropriate service to meet their needs. People could be referred to a social prescribing service for support with issues impacting on their mental health such as social isolation.

The provider had effective approaches to monitoring people’s care and treatment, and their outcomes.Monitoring arrangements were in place whereby key performance indicators (KPIs) were reviewed monthly by senior managers and the trust board. The provider used this data which had been agreed with the commissioners to monitor their performance and improve outcomes for people. The performance areas reviewed were:

• Patients who had left without being seen
• Unplanned patients who had reattended within 7 days
• Patients seen within 4 hours
• Patients seen within 2 hours
• Patient demand
• Patient attendance.

When the service did not meet performance targets, the management team monitored progress monthly and implemented action plans to drive improvement. Performance data from March 2024 to March 2025 showed that the service met or was close to meeting most key indicators. The provider tracked performance using a dedicated governance dashboard, which monitored risk, safety, and performance issues across all urgent treatment centres.

The service used information relating to incidents, complaints, patient feedback and other healthcare professional feedback to inform performance, safety and effectiveness and to identify and drive improvements.

Clinical audit was undertaken to monitor and improve outcomes for people. There was a clear system of regular audit in place that included monthly reviews of antimicrobial prescribing, the triage system, infection prevention and control, medicines management and clinical documentation. We found that low volumes of data were collected as a proportion of total clinical activity and this needed to increase. The service conducted local audits to gain assurance of adherence to specific processes or pathways. For example, pathway, triage audits and emergency resuscitation equipment audits. More recently a local audit was completed on compliance with management of animal bites. This demonstrated there was a high level of consistency amongst nurse practitioners in both their assessment and clinical decision making. There was a system to monitor non-medical prescribers in relation to the assessment of patients, the prescribing of medicines and associated outcomes for people who used the service.

The provider undertook an external quality assurance review commissioned by the trust board. The overall objective of the review was to provide assurance that systems and processes were in place to accurately report performance against the service KPI’s. The results of the review indicated its overall assurance was rated as high, especially for how performance was mapped up to the trust board.

People were provided with information about their care and treatment to enable them to make an informed decision. Staff understood the importance of ensuring that people understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Staff had undergone training in the Mental Capacity Act to enable them to understand the requirements of legislation and guidance when considering consent and decision making.