Dudley Urgent Care Centre

Updated 28 July 2022

Dudley Urgent Care Centre is situated in Russells Hall Hospital which is based in the Dudley area of the West Midlands. The provider organisation is Malling Health (UK) Limited. The service provides urgent care and out-of-hour GP services for its member practices as well as a streaming (redirecting patients to appropriate care) service situated at the entrance to the emergency department. The service is designed to see and treat patients who do not require emergency care and reduce the pressure on the emergency department. The service location is accessible to those with limited mobility.

The Urgent Care Centre offers non-emergency care for walk-in patients with minor illnesses and injuries that need urgent attention. These services are available to patients 24 hours a day, seven days a week. Patients can attend the Urgent Care Centre directly which is accesses through the Emergency Treatment Centre. Patients can also be referred to the Urgent Care Centre by the NHS 111 service. NHS 111 is a telephone-based service where callers are assessed, given advice and directed to a local service that most appropriately meets their needs.

The service has approximately 24 staff directly employed by the organisation including an Operations Manager. Most of the clinical staff working at the service which consists of GP’s, advanced nurse practitioners (ANP), paramedics, nurses and healthcare assistants (HCA) are either bank staff (those who are retained on a list by the provider) or agency staff. The area management team consists of a Director of Operations and a Clinical Chair. At the time of our inspection the service was recruiting for a clinical lead and interim arrangements were in place to cover this role.

CQC registered the provider to carry out the following regulated services at the service:

• Transport services, triage and medical advice provided remotely
• Treatment of disease, disorder or injury
• Diagnostic and screening procedures

The service’s website address is www.malling.health/

Updated 28 July 2022

This service is rated as Good overall. (Previous inspection March 2019 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced focused inspection at Dudley Urgent Care Centre on 26 May 2022 following a review of information we held about the provider which triggered the inspection. We did not include the key lines of enquiry related to caring and responsive services, as there were no risks identified with these key questions.

At this inspection we found:

• Safeguarding processes were in place. Staff had access to policies and referral information.
• Infection control processes were in place and the premises were visibly clean.
• The service had systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines. However, the service was not meeting the targets specified by its commissioners.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• The organisation had procedures in place for staffing, however we found instances where rotas were unfilled, and this had the ability to impact on timely assessment and treatment.
• Patients were not always able to access care and treatment from the service within an appropriate timescale for their needs and there were processes in place to mitigate risk, however recruitment of clinical staff was an ongoing challenge with 27% of shifts unfulfilled during the last 13 months.
• Governance processes needed embedding further as we found fridge temperatures were not being routinely monitored and escalated.
• Leaders understood the challenges and were working to make improvements in the service, however some systems and processes had recently been established and needed to be embedded further. For example, shift lead role, huddle meetings and escalation processes to manage patient flow and demand.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Continue to monitor that governance and clinical escalation processes are effective and make further improvements as needed.
• Continue to monitor recruitment and make further improvements in staffing where needed.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care