Inspection by the Care Quality Commission has resulted in a major NHS service being placed into special measures.
England’s Chief Inspector of General Practice found that the performance of the Peterborough out-of-hours service was below the required standard, and instantly imposed the extraordinary conditions with the hope of improving the situation.
The out-of-hours service provides urgent medical care outside of normal GP hours.
Inspections of the service found that it was utterly inadequate, with safety, efficiency and leadership problems all cited as being problematic.
There was only one crumb of comfort for the Peterborough-based service; it was rated as good for providing caring services.
This does at least suggest that the fundamental purpose of the organisation is being met to a certain degree.
However, the report from the Care Quality Commission identifies a number of areas where improvements must be made.
Nurses did not have access to adequate guidance and there was no evidence that they had been properly trained to deal with certain types of demanding calls.
There were also massive problems with recruitment procedures, and staff files were not kept up to date adequately.
Inspectors were also concerned that the service failed to deliver efficient and timely care and treatment to patients, with response times also rather inconsistent.
And despite the inadequate service that the out-of-hours service is currently providing, there was no evidence of a coherent plan to improve the situation.
Following the inspection, the Care Quality Commission shared its concerns and conclusions with numerous key stakeholders including Trust Development Authority, NHS England and Cambridgeshire and Peterborough CCG.
The trust has already submitted an action plan in response to these concerns, which attempts to address the issues raised by those who inspected the facility.
Commenting on the issue, Janet Williamson, Deputy Chief Inspector of General Practice and Dentistry in CQC’s Central region, provided her take on the problems.
“We found that patients were at risk because systems were not always in place to keep them safe. The provider must ensure that all staff who triage patients have been adequately trained to make clinical decisions by telephone and have been assessed. The service must ensure that the time patients wait for thorough clinical assessment is properly monitored to ensure patient care does not suffer. There must be enough staff on site to keep people safe.”
Williamson also outlined what the commission expects to see achieved in the future.
“Clear arrangements must be put in place to ensure that managers have effective oversight of the performance of the out-of-hours service at all times so that they can take appropriate action to minimise the risks to patients. It is important that the people who use the GP out-of-hours service for Peterborough and surrounding area can rely on getting the high quality care which everyone is entitled to.”
And concluded by explaining the situation going forward.
“We will continue to monitor this service and we will inspect again in six months to check whether improvements have been made. I hope that the service will take the necessary steps, but if we find that the service remains inadequate, we will consider taking further action.”
Dr Neil Modha, Chief Clinical Officer for the Cambridgeshire and Peterborough CCG, acknowledged the problems and resolved to make improvements.
“The CCG has worked closely with CCS since the inspection to ensure implementation of their recovery plan and we have been pleased with the progress and improvements in areas where quality of care were of concern. We will continue to monitor this progress so we can be assured that patients are receiving the high standard of out-of-hours care that we expect.”