Archived: Practice Plus Group - NHS 111 London

Updated 21 June 2017

Care UK, was founded in 1982, and the company is a large UK based independent provider of health and social care. Their services include treatment centres, GP practices, NHS walk-in centres, GP out-of-hours, prison health services and clinical assessment.

The service covers arears that are classified as the fourth most deprived decile on the index of multiple deprivation. The majority of the patients are either young or of working age. A small percentage of patients are aged between 65 and 85. The service is above the national average for patients aged between 20 to 40 and 0-14 and below the national average for patients aged between 65 and 85.

The health of people is lower when compared with the national average. For example, 44% of people have a long-standing health condition, comparable to the national average that is 53%. The lower percentage of people with a long-standing health condition could mean a lower demand for services including 111 services.

Care UK (NHS 111 London) was registered as a location in October 2011 and operates from:-

Unit 1

Square One

Navigator Park

Southall Lane

UB2 5NH

The provider holds the contracts for 12 NHS 111 services across a range of geographical areas in England, including the South West and South East of England, London, and parts of the Midlands and East of England.

Care UK (NHS 111 London) provides services in North West London, including Brent, Harrow, Ealing, Hounslow and Hillingdon. It is a telephone-based service where people are assessed, given advice and directed to a local service that most appropriately meets their needs. People can call 24 hours a day, 365 days a year, and calls are free from landlines and mobile phones. The NHS 111 service is staffed by a team of trained health advisors, supported by clinical advisors who are experienced nurses and paramedics.

Care UK (NHS 111 London) employs 165 staff. The service reported an approximate 25% turnover of staff in non-clinical and clinical roles in the past year. The call centre handles around 202,000 calls each year.

The provider is registered to provide three regulated activities:

• Treatment of disease, disorder or injury;

• Diagnostic and screening procedures;

• Transport services, triage and medical advice provided remotely.

This is the first comprehensive inspection of the NHS 111 service provided by Care UK (NHS 111 London).

Updated 21 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Care UK (NHS 111 London), Unit 1, Square One, Navigator Park, Southall Lane, UB2 5NH on 13 and 14 March 2017, at its single site location.

Our key findings were as follows:

Care UK (NHS 111 London) (the provider/the service) provided a safe, effective, caring, responsive and well-led service to a diverse population in London. Overall, the provider was rated as good.

• There was an open and transparent approach to safety and an effective system in place to report and record significant events. Staff knew how to raise concerns, understood the need to report incidents and considered the organisation a supportive, culture. The provider maintained a risk register and held regular internal and external governance meetings.
• The service was monitored against a National Minimum Data Set (MDS) and Key Performance Indicators (KPIs). The data provided information to the provider and commissioners about the level of service provided.
• Staff had been trained and were monitored to ensure they used NHS Pathways safely and effectively (NHS Pathways is a licensed computer-based operating system that provides a suite of clinical assessments for triaging telephone calls from patients based on the symptoms they report when they call).

• Patients using the service were supported effectively during the telephone triage process and consent was sought. We observed staff treated patients with compassion and respect.

• Staff took action to safeguard patients and were aware of the process to make safeguarding referrals. Safeguarding systems and processes were in place to safeguard both children and adults at risk of harm or abuse, including calls from children and frequent callers to the service.

• The provider was responsive and acted on patients’ complaints effectively and feedback was welcomed by the provider and used to improve the service.

• There was visible leadership with an emphasis on continuous improvement and development of the service. Staff felt supported by the management team.

• The provider was aware of, and complied with, the Duty of Candour. Staff told us there was a culture of openness and transparency.

We saw one area of outstanding practice.

• People are protected by a strong comprehensive safety system that identifies opportunities to learn and shares that learning internally and externally.

There were areas where the provider should make improvements:

• Continue to address the challenges of recruiting substantive staff and the high reliance on agency staff to ensure adequate numbers of skilled staff are available to provide a safe and effective service.
• Improve the process for documenting discussions, decisions and actions for internal meetings for audit purposes, including but not limited to, appraisals and development meetings.
• Consider ways to engage with a variety of patient representative groups.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice