Archived: Basingstoke and North Hampshire Hospital Also known as Hantsdoc

Updated 15 May 2017

HantsDoc, is an out of hours GP service, is run by North Hampshire Urgent Care (NHUC) which is a not for profit, community benefit society, run by a membership. North Hampshire Urgent Care’s head office is based at:

The Meads Business Centre, 19 Kingsmead, Farnborough, Hants GU147S

NHUC also runs another service from the same head office based at Frimley Park Hospital, which is the subject of a separate report. The two locations have a total catchment of about 640,000 patients.

We inspected the location HantsDoc which is located in the fracture clinic of:

Basingstoke and North Hampshire Hospital (A&E)

Aldermaston Road

Basingstoke

Hampshire

RG24 9NA

The service was open between 6.30pm and 8am Monday to Friday, and from 6.30pm on Friday evenings until 8am on Monday mornings at weekends and on bank holidays.

The service sees approximately 40,000 primary care patients per year. Approximately 44% of patients who contacted the service receive self-care advice over the phone, 48% are seen at the primary care centre and 8% receive visits at their home. The service is commissioned by one clinical commissioning group (CCG), which is the North Hampshire CCG.

Patients can access the service via the NHS 111 service.

NHUC employs a total of 185 staff across the Frimley Park and Basingstoke locations including 60 nurses, 38 drivers and 25 receptionists. GPs are self-employed contractors and therefore not included in the employee numbers. All staff, including contracted GPs are supported by a clear leadership structure, which consists of two medical directors, a chief executive, a chief nurse and a board of executive and non-executive directors. They are responsible for oversight of service provision and there are a range of meetings to monitor performance, such as clinical and risk governance.

The clinical workforce is made up almost entirely of a pool of local GPs and nurses and there is a low use of locum agency staff. Of the nursing staff 74% are advanced practitioners with prescribing rights.

Two medical directors, one GP elected to the NHUC council, a chief nurse and lead nurse all work at the Basingstoke service clinically as well as at a senior level behind the scenes.

Updated 15 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at North Hampshire Urgent Care Limited - Out of Hours GP Service (HantsDoc) on 21, 22 and 23 February 2017. Overall the service is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
• Risks to patients were assessed and well managed.
• Patients’ care needs were assessed and delivered in a timely way according to need. The service met the National Quality Requirements.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• There was a system in place that enabled staff access to patient records, and the out of hours staff provided other services, for example the local GP and hospital, with information following contact with patients as was appropriate.
• The service managed patients’ care and treatment in a timely way.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

• Review the systems for monitoring individual medicines in order that there is a running total of all individual tablets and vials of medicines readily available.

We saw one area of outstanding service:

• The standard clinical system used by the majority of out of hours providers only categorises patients as urgent or routine, however the dispositions (recommended course of action) given by NHS 111 provide more options, for example, to be contacted within 30 minutes, one hour, two hours, six hours. The provider realised that patient prioritisation would be improved if the clinical system options matched the NHS 111 dispositions. The provider has developed in- house options within the clinical system so that the system shows patients in the same priorities as the dispositions that were assigned by NHS 111. We saw evidence that this had reduced the time patients were waiting for contact with the primary care centre, for example, the average time patients whose disposition was to be contacted within an hour had been reduced to under 30 minutes.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice