Archived: Urgent GP Clinic

Updated 22 June 2017

The Urgent GP Clinic is situated in Luton and Dunstable Hospital which is based near the town centre of Dunstable, Bedfordshire. The service provides urgent care GP services. The service is part of Local Healthcare Solutions Limited, which has a board comprising of 10 GP partners. The local management team consists of a Chief Executive Officer (CEO), a Chairman, who is a local GP, a non-Executive Director and two additional local GPs hold the roles of Clinical Director and Medical Director.

The clinical team consists of two salaried GPs (one male, one female), three health care assistants and a large number of long term locum GPs and agency nurses. The teams are supported by a service manager, a personal assistant to the CEO and a team of receptionists. At the time of inspection the senior nurse post had become vacant and the decision of the Board was to recruit a Director of Nursing to support the service.

The service was commissioned to reduce the number of non-emergency care for walk-in patients with minor illnesses and injuries that need urgent attention. These services are available to patients 365 days a year between 8am and midnight. The service was extended until 1am during January to March 2017 to support the A&E department through the winter months.

Patients can attend the Urgent GP Clinic directly through the A&E Department at the Luton and Dunstable hospital. On attending the front desk, patients are ‘streamed’ by a clinician and referred to the urgent care centre or to the A&E Department; based on their symptoms. On average 6,200 patients each month attend the A&E department of which approximately 3,100 (50%) patients are referred to the service.

Updated 22 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Urgent GP Clinic on 1 March 2017. Overall the service is rated as good.

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

• The service had clearly defined and embedded systems and processes in place to keep people safe and safeguarded from abuse. There were effective arrangements in place to the support processes for identifying, recording and managing risks.

• Evidence demonstrated that the service effectively managed incidents and significant incidents, which were communicated to staff by email.
• 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.
• There was a system in place that enabled staff access to patient records, and the urgent care centre staff provided other services (for example, the patient’s GP or the hospital) with information following contact to ensure continuity of care.
• We observed the premises to be visibly clean and tidy. There was an infection control policy in place and a named lead for infection control concerns who liaised with the lead from the hospital.

• A programme of continuous case audits and prescribing reviews was in place, findings were used to monitor quality and to make improvements.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The service had good facilities 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 the requirements of the duty of candour. Examples we reviewed showed the service complied with these requirements.

The areas where the provider must make improvement are:

• Ensure review of clinical governance systems and process for clinical quality assurance to ensure effectiveness for patients, introduce auditing of clinical data and patient feedback systems and act on the findings.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Service