John Coupland Hospital

Updated 30 September 2014

The GP out-of-hours service for Lincolnshire is provided by Lincolnshire Community Health Services NHS Trust. The service is commissioned by the four Lincolnshire Clinical Commissioning Groups (CCG’s), with the lead for out-of-hours services being Lincolnshire East CCG.

The out-of-hours service provides care to patients who required urgent medical care from a GP outside of normal GP hours.102 GP practices were covered by the service. The provider employed the services of 100 GPs who were engaged on a sessional basis to deliver care to patients. The service operated county wide from 6.30pm to 8am Monday to Thursday, 6.30pm Friday to 8am Monday, and all public holidays

John Coupland Community Hospital, Gainsborough however was only open for out-of-hours service from 10am to 2pm on Saturday, Sunday and Bank Holidays.

Initial telephone contact with the out-of-hours service is through the NHS 111 system, a service provided by another healthcare provider.

The out-of-hours service was split into three ‘Business Units’, which comprised the North West, East and South business units. They were geographically aligned to Lincolnshire’s Clinical Commissioning Groups.  The out-of-hours service in each was managed by an Urgent Care Matron.

The service provided care to a population of 723,000 residing in an area of 2,350 square miles from eight primary care centres geographically spread across the county. The eight locations were;

The County Hospital, Lincoln                                      

John Coupland Community Hospital, Gainsborough  

Grantham and District Hospital                                   

Stamford and Rutland Hospital, Stamford                  

Johnson Community Hospital, Spalding                     

The Pilgrim Hospital, Boston                                      

Skegness and District Hospital                                   

County Hospital, Louth                                               

In the year 2013/14 in excess of 100,000 patients accessed the out-of-hours service.

This inspection focused on the out-of-hours service at John Coupland Community Hospital in Gainsborough.

Updated 30 September 2014

Lincolnshire Community Health Services NHS Trust provided out-of-hours General Practitioner (GP) services for patients living in Lincolnshire. The service was administered from the trust’s headquarters in Sleaford and patient care and treatment was provided from eight primary care centres at locations across the county. We visited the trust’s headquarters on 5 June 2014 where we looked at records and information and talked with staff about issues that related to all eight locations and the service a whole. On the 7 June 2014 we visited the primary care centre at John Coupland hospital and spoke with members of staff, patients and carers and reviewed documents and matters specific to that location.

Lincolnshire Community Health services NHS Trust (referred to in this report as ‘The provider’) provides OOH GP services for patients living across Lincolnshire from eight locations. We have inspected the eight locations and this reports is in relation to our inspection of the location at John Coupland Community Hospital

The provider conducted clinical audit that addressed specific areas of patient care. Individual clinicians’ practice was assessed on a regular basis to help ensure that patients received safe and effective care and treatment.

We found the service was effective in meeting patients’ needs and the primary care centres were accessible to those who may have had mobility issues.

The reception used Language Line for interpretation purposes if required. They had a laminated sheet available in numerous languages for patients to identify the language they spoke. There was a book available specifically to assist Polish speaking patients. Lincolnshire has a large number of resident Polish migrant workers.

There were systems in place to help ensure patient safety through learning from incidents and infection prevention and control.

Staff were trained and supported to help them recognise the signs of abuse of children and vulnerable adults.

The provider had not used effective recruitment processes to assess the suitability of staff to work in this sector. We have told the provider they must improve

Patients experienced care that was delivered by dedicated and caring staff. Patients and carers we spoke with said staff displayed a kind and caring attitude and we observed patients being treated with respect and kindness whilst their dignity and confidentiality was maintained.

The provider had in place business continuity and contingency plans that would enable the service to continue to operate in the event of a failure of, for example, the information technology or telecommunication systems.

We found that the service was well-led and managed by a knowledgeable senior management team and Board of Directors at provider level. They had taken action to help ensure their values and behaviours were shared by staff through regular engagement.

At John Coupland Community Hospital out-of-hours there was only one GP on duty. The GP told us that he felt supported by the clinical lead and held positive views of the management team and their leadership. He told us the senior managers were approachable and listened to any concerns or suggestions he might have to improve the level of service provided to patients.