Eastham Walk In Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This was the first comprehensive assessment for this service as a location registered with CQC. This key question has been rated as requires improvement. We have identified a breach of regulation for the management and governance of incidents and the management of risk associated with staffing and staff training.

This service scored 54 (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 a strategy with clear objectives to achieve priorities. The strategy was in line with meeting the health priorities across the locality. The provider planned the service to meet the needs of the local population working in collaboration across the wider system of primary, secondary and urgent care. Leaders worked in partnership with relevant stakeholders to monitor and deliver the strategy.

A range of management and governance meetings were held regularly where performance against a range of indicators was reviewed, evaluated and action planned to make improvements as required.

Members of the staff team spoke of a vision to provide a high quality, patient centred service that was responsive to people’s needs. The staff team demonstrated a patient centred approach. Staff understood their roles and responsibilities and told us they felt positive about working at the service in terms of providing a person-centred service. They described good teamwork and a service that was clear on its function to work in the interests of patients and provide the best patient experience they could. However, staff were not always positive about the culture at leadership level as they felt they were not being listened to when they raised concerns about staffing and the potential impact on patient experience and patient safety.

We were not assured that the governance of incidents and complaints always demonstrated openness and transparency or supported a safe learning culture.

The leadership team worked in collaboration with other agencies, stakeholders and commissioners and were engaged in the development of services within the locality to support patient experience and improve outcomes for patients.

We received feedback from several staff. The main themes were that staff felt proud to work at the service, worked well as a team at local level, felt they delivered a good service despite constraints, they were positive about the variety and challenge presented by working in the service and felt well supported with their professional development. However, staff also reported low morale, burnout, not having time to attend meetings and undertake appropriate and necessary training, feeling rushed and unsafe at times and not always able to take annual leave. Staff shortages were reported to be a long-term concern that had increased in the past 12 months.

Systems in place for communication were not always clear or effective. We found a level of disconnect/conflicting information between the information shared by front line staff, management and leadership - for example, with regards to the movement of staff, levels of staff sickness and staff training. We were not assured that information relating to incidents, complaints, patient feedback were shared effectively with members of front-line staff to inform safety and performance.

We noted issues and concerns from a previous broader inspection of the trust that had included this service (carried out in 2018) were recurring or continuing. These were linked to concerns about identifying and mitigating risks related to staffing, staff feeling their voices were not being heard and acted upon, concerns with regards to the skill mix of staff, staff access to training, and the effectiveness of communication.

The service had established freedom to speak up arrangements. There was a dedicated ‘freedom to speak up’ person that staff could approach. There was also a whistleblowing policy.

Leaders told us they encouraged staff to raise concerns and promoted the value of doing so. However, staff told us they did not feel listened to or that their concerns were being acted upon or addressed.

A more localised/focused staff survey had been undertaken in August 2025 and actions were planned in response to the findings from this.

The provider valued diversity in their workforce and actively promoted equality and diversity. Leaders took steps to remove bias from organisational practices and ensure equality of opportunity and experience for all staff. The trust had a dedicated team to support inclusion and steer the provider’s inclusion agenda. This was supported by champions for patients and for staff.

Leaders described proactive approaches to engage and involve staff. However, feedback from front line staff indicated that they did not feel empowered or confident that their feedback, concerns and ideas were listened to or led to meaningful change. Some staff told us they had not been able to take annual leave due to staff shortages. This disadvantaged members of the team.

Staff had completed training in equality, diversity, and inclusion and were aware of supporting people with protected characteristics such as age, gender, religion, or disability.

Systems were in place as would be expected in NHS trust to ensure active recruitment and support for a diverse workforce.

The service was governed by the trust infrastructure with a number of directorates, reporting systems and governance frameworks.

The findings of our assessment of the arrangements for managing and governing incidents and complaints indicated that these were not always fully effective.The governance framework included a ‘Clinical Quality and Safety Group’ (CQSG) for reporting and oversight of incidents but we were not assured that this was fully effective based on our findings about how incidents were managed. The governance of incidents did not ensure a comprehensive investigation with learning and timely actions being taken.

We found a level of disconnect between the management and governance of the service at provider level and the location level. This may have been compounded by the way in which information was communicated to front line staff.

There were arrangements for identifying, managing, and mitigating risks and oversight of this sat within the Specialist Medical Directorate. An overarching risk register was in place and this had identified risks to operational delivery due to staff sickness and staff vacancies and the associated risk of not being able to release staff to attend training. Similar issues were sighted in May 2025 in a workforce report to the Integrated Performance Board. Risks were reviewed at monthly service level meetings and monthly directorate meetings. However, staff told us that concerns about staffing had been raised over a long period of time and increasingly so over the past 12 months but that they had not seen any improvements to date.

The provider did not have clear oversite/governance of staff training outside of core mandatory training – both in terms of requirements and attainment. Staff told us they required more guidance and standard operating procedures to support them in their role. A number of standard operating procedures were produced recently or in response to our findings. For example, a pressure escalation process, and a policy for managing patients who present with a mental health concern. A standard operating procedure for managing patients presenting with chest pain was not in place despite this having been established as being required following a patient safety event.

Communication between leaders/managers and front-line staff was not always effective. The provider had recognised this and during the course of our assessment changes were made to the format of the daily ‘huddle’ meeting and leaders were reviewing the arrangements for wider team meetings.

The provider planned services to meet the needs of the local population working in collaboration across the wider system of primary, secondary and urgent care. The provider worked in partnership with relevant stakeholders, commissioners and partner agencies to support joint working and provide and develop services. The service strategy was in line with meeting the health and care priorities across the locality.

The provider worked in partnership with Healthwatch, the ICB and Emergency Department (ED or AE) to establish a Wirral wide high intensity user programme to support people who attended an ED or urgent treatment centres more frequently than expected.

Members of the leadership team met with commissioners from Cheshire and Merseyside Integrated Care Board - Wirral Place on a regular basis and shared performance data.

The provider did not consistently demonstrate learning and improvement. Processes to ensure that learning from incidents was communicated and acted upon was not effective and action to prevent a reoccurrence was not timely including in collaboration with external partners and services.

Service leads attended an established monthly Wirral system-wide pre-hospital group meeting where stakeholders came together to engage in discussions around service provision, explore ways to improve care pathways, share improvements being implemented and focus on ways to improve access to pre-hospital services for people in the locality.

A reconfiguration of services programme was underway and anticipated to be fully implemented by summer 2026. A formal programme board was responsible for driving this and maintaining oversight. The provider told us they had a focused view on the workforce to ensure this was going to be fit for the future in line with changes to service provision.