Archived: MedOCC-Quayside

Updated 25 June 2015

The service is commissioned by the Clinical Commissioning Group to provide out of hours consultations to patients registered with local GPs in the Medway and Swale locality. The service is provided Monday to Friday 6.30pm to 8am and 24hrs at weekends and bank holidays.

Patients accessed the service via their own GP telephone answering system which redirected them to the 111 service. Patients were triaged and prioritised by 111 services they were contacted and offered a timed appointment. There are GPs and nurses available Monday to Sunday supported by receptionists offering 15 minute appointments.

The service delivers out of hours services across the local region at four sites (MedOCC @ Medway, Medway Maritime Hospital, Gillingham, Kent. MedOCC Quayside House, Chatham, Kent. Sheppey Community Hospital, Isle of Sheppey, Kent and Sittingbourne Memorial Hospital, Sittingbourne, Kent). The premises used are either independently run or are within an NHS Trust, where the premises are shared.

MedOCC forms part of Medway Community Healthcare C.I.C. The service deals with urgent care problems when GP surgeries are closed or when they are unable to offer patients same day appointments. For example, they assess and manage patients with cellulitis and deep vein thrombosis and act as a communication hub for messages to district nurses, health visitors, rapid response teams and other community/specialist teams. Consultations are provided on an appointment basis only. MedOCC does not offer a ‘drop in’ service. There are referral pathways for patients to transfer to the primary care service from Accident and Emergency (A&E) from community teams and from the 111 service. Patients may be given advice over the telephone or are seen in any of the MedOCC sites or the GP may visit someone in their own home depending on the circumstances.

The service is staffed by GPs on a sessional basis. There are eight salaried GPs (six and a half whole time equivalents) and approximately 90 GPs who work for the service on a sessional basis. There is one (who works four days out of five in a week) Senior Clinical Medical Officer, nine nurses (of which some are independent nurse prescribers) and 32 drivers.

We visited three sites as part of our inspection

• MedOCC @ Medway, Medway Maritime Hospital, Gillingham, Kent.
• MedOCC Quayside House, Chatham, Kent.
• Sheppey Community Hospital, Isle of Sheppey, Kent.

Updated 25 June 2015

We carried out an announced comprehensive inspection at MedOCC Quayside (the out of hour’s service) on the 27 and 29 November and 3 December 2014. During the inspection we gathered information from a variety of sources. For example, we spoke with patients, interviewed staff of all levels and checked that the right systems and processes were in place.

Overall the out of hours service is rated as good. This is because we found the service to be good for providing safe, effective, caring and responsive services. It was also good for providing services for all patient population groups.

Our key findings were as follows:

• Access to the service was effective.

• There was a clear management structure to support and guide staff.

• There were systems to ensure patients received safe and effective care. We saw examples of how GPs and other staff had learned from complaints and incidents.  A programme of continuous auditing was to assess the services quality and productivity.

• The service had good facilities and was well equipped to treat patients and meet their needs. Services were provided in facilities which were clean and well maintained. The service had an effective infection control system to ensure that the risk of infection was minimised.

• We saw staff treated patients with dignity and respect. Patients made positive comments about staff and how they were treated. Some patients were unhappy about the length of time they had waited but were confident they would receive a good service when they were seen.

• Evidence based guidelines provided the service with clear guidance on how services should be provided. These included guidelines for the treatment of deep vein thrombosis and cellulitis and a list of conditions the service was not able to treat. This meant staff had clear protocols for treating patients which was updated to reflect changes in practice.

• The service implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients.

• Patients were provided with medicines if their need was urgent or if the pharmacies were closed. 

• Reception staff had received customer care training which helped them overcome some of the difficulties they experienced in open reception areas, to help ensure privacy and confidentiality.

Letter from the Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice