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Care Quality Commission publishes report on Norfolk out of hours and NHS 111 service

5 July 2016
Integrated Care 24 - Norfolk & Waveney
  • Media

England’s Chief Inspector of General Practice has published a report on Integrated Care 24 (IC24) Norfolk and Wisbech following a focused inspection by the Care Quality Commission.

The Care Quality Commission carried out an unannounced inspection at the service, which provides the NHS 111 and out-of-hours services for approximately 830,000 people living in Norfolk and Wisbech, on 16 March.

Under CQC’s programme of inspections, all of England’s GP and out of hours services are assessed on whether they are safe, effective, caring, responsive and well led.

The inspection at IC24 Norfolk and Wisbech took place following information of concern that had been highlighted to CQC and focussed on safety and leadership at the service.

Inspectors found the service needed to make a number of improvements to ensure people received a consistently safe and effective service, including:

  • Out-of-hours staff who triage patients must be adequately trained to make clinical decisions by telephone and have been assessed as competent to do so. In addition, protocols and guidelines must be implemented to guide staff to make safe and appropriate decisions with regard to how people’s needs are assessed and dealt with.
  • Prioritising ongoing work to investigate and tackle the causes of delays relating to patient care.
  • Ensuring medicines held at primary care centres are within the manufacturers’ recommended expiry dates and make sure there is an effective process for managing this.
  • Putting systems in place to ensure staff files and recruitment procedures are effectively recorded.
  • Undertaking Disclosure and Barring Service checks for all staff in a timely and orderly manner.
  • Ensuring sufficient and appropriately trained staff are present at all primary care centres and that contingency arrangements for staff to follow are agreed for when gaps in GP cover arise.

CQC is working closely with the CCG and NHS England with regard to the service to ensure sustainable improvement takes place.

Janet Williamson, Deputy Chief Inspector of General Practice and Dentistry in CQC’s Central region said:

“Our inspectors found that systems and processes to help prevent patients being put at risk of harm were not always in place.

“There were delays in patients accessing the 111 and the GP out-of-hours service, the systems to show that staff had been appropriately trained and security checked were ineffective and we found some medicines were out of date. We have told the service to take action to address these and other issues.

“However, we also found evidence that the new leadership had already taken action to address some areas of concern, indicating that they are capable of making these improvements.

“We will return to this service again soon to check it has taken action to ensure everyone who uses this service gets safe, high quality care. If, when we return, we are not satisfied that this has happened we will consider taking further action.

“In the meantime, we will continue to work closely with the CCG and NHS England to ensure this service has the support it needs to improve, so that people in Norfolk and Wisbech get the out-of-hours care they deserve.”

A full report of the inspection at IC24 Norfolk and Wisbech has been published today.


For media enquiries, call Regional Engagement Manager, Louise Grifferty on 07717 422917. For media enquiries about the Care Quality Commission, please call the press office on 020 7448 9401 during office hours. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here (please note: the duty press officer is unable to advise members of the public on health or social care matters). For general enquiries, please call 03000 61 61 61.

Last updated:
29 May 2017

Notes to editors

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.