Arrowe Park 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 this assessment we rated the service as good.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff had access to information they needed to assess, plan, and deliver care, treatment, and support effectively. A Standard Operating Procedure (SOP) set out the minimum standards and processes to be followed by all clinical staff responsible for the initial assessment of patients in the UTC. It aimed to ensure safety, consistency, and alignment with national guidance, while allowing flexibility to accommodate local service configuration and patient case mix. However, this SOP to support staff with their initial assessment was not introduced until September 2025.

The SOP directed staff to make initial observations of patients and to provide any immediate care or treatment, such as pain relief or temporary dressings, as needed. Staff prioritised patients who were acutely unwell or vulnerable for a comprehensive assessment following triage. However, the SOP did not state when or whether staff should repeat observations for patients who were less unwell whilst they waited for full assessment and treatment.

The service utilised a nationally recognised scoring system such as NEWS2 (National Early Warning Score 2) for adults and PEWS (Paediatric Early Warning Score) for children to assess the severity of acute illness. The forms were used to standardise the process of identifying and responding to patient deterioration.

Nationally recognised tools were used to triage patients with a variety of presenting conditions, to identify clinical priorities, and to ensure that those with the most urgent needs were seen first. To promote patient safety and service efficiency, the team aimed to complete initial assessments within 15 minutes of arrival at urgent care. However, the system for triage, prioritisation, and assessment was not effective, as initial assessments were consistently not completed within the expected 15-minute timeframe. In June 2025 the provider introduced a new acuity tool to simplify the assessment process, but improvement was not demonstrated at the time of our assessment.

Staff reviewed each patient’s condition, recorded vital observations, assessed the clinical issue, and provided treatment when needed. Managers audited clinical consultations to ensure best practice was followed. During our on-site review of five clinical records, we identified an instance where vital observations had not been recorded as required, and we asked the service to investigate this. Following their investigation learning was identified.

The clinical team had access to patients’ in-hours GP notes to support their assessments. However, we could not be assured that GP notes or the summary care records were consistently reviewed during patient assessments.

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, non-clinical prescribing and clinical record keeping.

Our review of clinical records indicated that people mostly received care, treatment and support that was evidenced based and was in line with good practice standards. However, we were not assured that the audit of clinical record keeping was sufficiently robust to consistently identify issues and enable learning.

The provider had a training and development programme in place that was tailored to different staff roles and responsibilities. However, the provider was unable to demonstrate, from the evidence submitted, that this was effective. 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 understood service performance against key performance indicators and discussed performance at senior management and board level.

We found a lack of standard operating procedures, leading to inconsistent operations and unclear guidance for personnel.

Leaders and staff collaborated with colleagues and stakeholders to respond to urgent needs and support the wider healthcare system. Urgent Care leads attended monthly Wirral system-wide meetings where stakeholders came together to discuss service provision and improve care pathways. The Trust had established a Wirral High Intensity User programme with the emergency department to identify and support individuals aged 18 and over who attended the ED or UTC more frequently than expected.

They prioritised care for clinically vulnerable patients and worked with other professionals to deliver appropriate treatment. For instance, when patients required emergency care, patients could be easily transferred as the emergency department was on-site to provide immediate support. In addition, the service also had access to and support from the on-site in-hours and out-of-hours GP service.

After each consultation, the service sent an electronic record to the patient’s GP, and staff communicated to ensure GPs were informed of any required follow-up.

When patients moved between services, relevant staff and teams coordinated assessments to ensure continuity of care. However, we observed an instance where this process did not work effectively throughout a patient journey and that was not recognised as an area for learning when investigated.

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 care providers made aware so additional support could be given. Where peoples’ needs could not be met by the service, staff redirected them to the appropriate services that could. Staff were aware of services where people could be referred on to for support with issues impacting 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 by senior managers and the trust’s board.

The provider used data agreed with the commissioners to monitor their performance and improve outcomes for people. They attended a Contract Review Meeting (CRM) with the Integrated Care Board (ICB) every two months to review performance, contractual and financial matters. Performance was reported by exception with a short narrative provided for any KPIs not achieving targets. The last CRM took place in July 2025 (reviewing May 2025 data) when the Trust achieved 94.9% in-month against the 95% target. The KPI monitored was the percentage of patients seen and discharged within 4 hours. We spoke with the ICB who had no concerns.

When the service did not meet performance targets, the management team monitored progress monthly and implemented action plans to drive improvement. The provider tracked performance using a dedicated governance dashboard, which monitored risk, safety, and performance issues across all locations.

The trust used patient data, centre usage data, peak times, waiting times and trends to monitor and inform the service. The information provided included a geographic distribution of attendance showing where patients were travelling from to receive care from the UTC. They measured the causes leading to attendance and identified the top reasons being abdominal pain, wound care, and chest pain. They identified an increase in activity on Mondays and Sundays and considered review of staff rotas to reflect this demand.

Clinical audit was undertaken to monitor and improve outcomes for people. There was a clear system of regular audit in place that included for example, compliance with NICE guidance for head injury, pain assessment within UTCs, diagnosis of urinary tract infections for patients aged 65 years and an audit of antibiotic prescribing.

The service also audited clinical consultations. We found that the service collected a low proportion of data relative to total clinical activity, and increasing data collection would improve effectiveness. For example, in 1 out of 5 consultations we reviewed, the provider missed an opportunity for reflection and learning. We highlighted this to the provider, who took action to share learning and strengthen governance oversight.

However, the service did not consistently use information relating to incidents, complaints, patient feedback and feedback from staff to inform performance, safety and effectiveness and to identify and drive improvements.

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.

Leaders said that mental capacity act (MCA) training was included within the safeguarding modules but could not demonstrate that staff had undergone specific MCA training to enable them to fully understand the requirements of legislation and guidance when considering consent and decision making. This issue had been identified as an action but had not yet been completed.