Archived: GPEA Service, Waterlooville Hub

Updated 10 September 2019

Southern Hampshire Primary Care Alliance (SHPCA) is a federation of GP Practices reaching from Bordon in Hampshire, down the A3 corridor to Fareham and Gosport, and across to Hayling Island. All but three practices in the Fareham and Gosport Clinical Commissioning Group (CCG) and South East Hampshire Clinical Commissioning Group (CCG) areas are members. Patients from all practices, whether registered at member practices or not, can access the services.

SHPCA provides an extended hours GP service and also delivers phlebotomy and cardiology outpatient services. The community specialist services (cardiology and phlebotomy services) part of the alliance employs health care assistants, a phlebotomy supervisor and a service manager to deliver a phlebotomy service across the Gosport and Hayling Island areas. There is also a clinical lead who is a Director and GP from one of the member practices. The service is available through six local hubs (each one a registered location) and patients access the service by booking in with their own practice.

Portsmouth Cardiac Associates provide consultant cardiologists and cardiac technician staff to the alliance to deliver the cardiology outpatients service. SHPCA employs a service manager and healthcare assistant to administer and oversee the service. The cardiology service is intended as a non-urgent service. It can investigate palpitations, dizzy spells, suspected heart murmurs, breathlessness with unidentified cause, atrial fibrillation and pre-existing known cardiac conditions which are deteriorating. Access to the service is via GP referral.

The Integrated Primary Care Access Service (IPCAS) is delivered by SHPCA through five separately registered hubs. The service provides an extended hours service (patients can access GP and nurse appointments and book in advance to meet their needs) up until 8.30pm which can be accessed by patients via appointments booked in advance with their own GP practice. Between 8.30pm and 10.30pm the service operates an out of hours service which is accessed via NHS 111. Overall the alliance serves a population of 421,000 patients. The alliance started a new contract on 1 June 2019 to provide extended hours, out of hours and home visiting services to its population. The home visits and overnight out of hours parts of the contract are subcontracted to another provider. Each hub location has its own service level agreement supported by its own standard operating procedures (SOPs).

Staff supporting the IPCAS service are not directly employed by the alliance but are employed by member practices. They are paid by their own practice for shifts worked delivering the service.

The IPCAS service is provided from:

Forton Medical Centre, Whites Place, Gosport, PO12 3JP

Saturday and Sunday 8am to 10.30pm

Fareham Community Hospital, 233A Brook Lane, Sarisbury Green, SO31 7DQ

Monday to Friday 6.30pm to 10.30pm,

Waterlooville Health Centre, Dryden Close, Waterlooville, PO7 6AL

Monday Wednesday and Friday 6.30pm to 10.30pm

Saturday and Sunday 8am to 10.30pm

Portchester Health Centre, West Street, Fareham, PO16 9TU

Saturday and Sunday 8am to 10.30pm

The Swan Surgery, Swan Street, Petersfield, GU32 3AB

Tuesday and Thursday 6.30pm to 10.30pm

Saturday and Sunday 8am to 10.30pm

During the inspection we visited Waterlooville Health Centre and Fareham Community Hospital, which are registered locations.

Information about this provider can be found at www.shpca.net.

The inspection of the phlebotomy and cardiac services and two of the hub locations for the IPCAS service took place on 16 and 17 July.

Prior to the inspection we reviewed information we held about the service, publicly available information and information provided as part of the pre-inspection request. This helped us plan the inspection.

We used various methods to carry out our inspection of the various services. These included talking to people using the service, interviewing staff, observations and review of documents. We also reviewed patient records pertinent to the inspection and collected patient comment cards.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 10 September 2019

This service is rated as Good overall. This was the first inspection of this service.

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 comprehensive inspection at GPEA Service, Waterlooville, as part of our inspection programme. This was the first time we had inspected this service.

The service provides a primarily extended hours service to patients living in the Fareham and Gosport Clinical Commissioning Group and South East Hampshire Clinical Commissioning Group areas. The service also offers an out of hours service, for the same patient group, until 10.30pm when the out of hours is transferred to another provider.

There was no registered manager in post at the time of the inspection. The service had appointed one and they were in the process of being registered with the Care Quality Commission. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During the inspection we collected 24 comment cards and spoke with two patients. Feedback from patients was mostly positive. Patients found the service to be convenient and helpful, especially those who were working and would have had to take time away from work for a GP appointment.

Our key findings were:

• Staff had the information they needed to deliver safe care and treatment to patients.
• The service learned and made improvements when things went wrong.
• Patients received coordinated and person-centred care.
• Staff treated patients with kindness, respect and compassion.
• The service organised and delivered services to meet patients’ needs.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.

• Leaders were knowledgeable about issues and priorities relating to the quality and future of services. They understood the challenges and were addressing them.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.

The areas where the provider must make improvements are:

• Assess, monitor and improve the quality and safety of services.
• Assess, monitor and mitigate the risks relating to the health, safety and welfare of service users

The areas where the provider should make improvements are:

• Continue with the legionella risk assessment and review
• Continue with improved assurances in relation to emergency medicines
• Continue with processes to improve prescription stationery security
• Continue with processes to register the registered manager with CQC
• Improve frequency of staff meetings and ways of communicating with staff to ensure staff feel part of a team.
• Improve mentoring and development opportunities for staff
• Establish a system to provide assurance that locums, not employed in member practices, receive safety alerts and other updates.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care

Our inspection team

Our inspection team was led by a CQC lead inspector. The team included a CQC Inspection Manager, a CQC team inspector, a GP specialist adviser and a practice manager specialist adviser.