Archived: University Hospital Lewisham - Urgent Care Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at South East London Doctors Cooperative Limited (SELDOC) Out-of-Hours (OOH) Service based at University Hospital Lewisham Urgent Care Centre on 24 February 2017. Overall the service is rated as requires improvement.

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

• The provider had an open and transparent approach to safety and a system in place for recording, reporting and learning from significant events and staff understood their responsibilities to raise concerns and report incidents and near misses. However, the location had not reported any incidents in the last 12 months.
• There were systems and processes in place to keep patients safe and safeguarded from abuse at an organisational level but no safeguarding referrals had been made in the last 12 months from the Lewisham location. This is not in line with a service of this type and size. Furthermore, the provider could not demonstrate that all GPs had completed safeguarding children and adult training or that the hospital trust staff undertaking chaperoning were trained and had received a Disclosure and Barring Service (DBS) check.
• The provider had processes and systems in place at an organisational level for the dissemination of NICE guidance, patient safety alerts and organisational and policy changes but could not demonstrate how it ensured the GPs working at the location consistently received these and that appropriate action was taken.
• 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.
• 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 operated within a hospital trust and was well equipped to treat patients and meet their needs.
• 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 must make improvements are:

• Ensure all staff are up-to-date with safeguarding children and adult training.
• Ensure that hospital trust staff undertaking chaperoning are trained and have received a Disclosure and Barring Service (DBS) check.
• Develop an effective system for sharing patient safety alerts and national guidance.
• Implement a process to keep staff at the location aware of local systems, protocols and policy changes.

The areas where the provider should make improvements are:

• Review how patient feedback is collected for each location and consider analysing data separately to ensure any findings and trends relevant to a specific location are being addressed.
• Review the privacy and dignity during examinations, investigations and treatment arrangements for patients.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice