Tower Hamlets Out of Hours GP Service

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection of Tower Hamlets Out of Hours GP Service on 28 September and 2 October 2023. The service had previously been inspected in October 2018, at which point the location was an out of hours service only. The inspection in October 2018 had rated the service as good overall, and in all five key questions.

The registered manager for the service had been the Director of Clinical Governance. The manager had recently departed the organisation and the service was in the process of appointing a new manager. 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.

At this inspection we found:

• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes. However, we saw in one incident reviewed that a report did not comment on the insufficient follow up arrangements for a patient.
• The service was not meeting key performance indicators as required by its commissioners for the number of patients categorised as urgent seen in two hours in the out of hours service.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the service easy to access and reported that they were able to access care when they needed it. The service was not ensuring a throughput of patients in line with its four-hour target.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure that care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Review how two separate databases are used to record patient information, and to store policies and procedures.
• Review monitoring procedures to ensure that expired equipment is removed from areas where it might be used.
• Review systems to ensure that all clinical staff are aware of learning from incidents.
• Review DBS security checking protocols so that the provider may be assured that they are up to date.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care