Sentinel Healthcare South West CiC

Updated 3 August 2021

Sentinel Healthcare South West CIC operates from headquarters at, Unit 1, 5 Research Way, Plymouth Science Park, Plymouth, PL6 8BT.

Sentinel Healthcare are registered to provide the following regulated activities:

• diagnostics and screening services
• treatment of disease, disorder or injury
• surgical procedures

Sentinel Healthcare South West Community interest Company (CiC) is owned by shareholders of GPs and practice managers in Plymouth, West Devon and South Hams. They provide services for patients and medical professionals in Devon and Cornwall. It is a ‘not for profit’ social enterprise company which expands patient centred services and invests any surplus in further patient services.

The service is funded both by the NHS and privately. NHS patients are referred by their GPs and private patients self-refer.

Sentinel Healthcare work with the local clinical commissioning groups, NHS England and other organisations. It provides NHS services, private services and shared services.

Services provided on behalf of the NHS include dermatology,ear, nose, and throat (ENT), vasectomy, cardiology, a musculoskeletal (MSK) interface service, diabetes structured education, and chronic fatigue syndrome.

Shared services include a training hub (training and development opportunities for health professionals) and disclosure barring service (DBS) checking facilities.

Private services offered include minor surgery which started in 2018 as it was no longer provided on the NHS.

As part of the national emergency response associated with COVID19, Sentinel had been redeployed to run fever centres in West Devon. This was to provide much needed support to General Practice services and the wider health system, and to alleviate the pressure on 999 services. They had also helped establish and run the Pavilions Vaccination Centre which delivered over 58,000 vaccinations.

The service is led by a strategic director and operations director who coordinate a team of up to 80 administration and clinical staff. Clinical staff include GPs with special interest (GPwSI), extended scope practitioners (physiotherapists), podiatrists, occupational therapists, hospital consultants, osteopaths, nurses, practice nurses and health care assistants.

Sentinel Healthcare rents clinical and office space across 11 different locations including community hospitals, GP practices and Derriford hospital. They provide clinical services close to the patient population which reduces the need for patients to visit large acute hospitals in the locality. The service also rents other locations for health education and non-clinical purposes. These include community centres, libraries, village halls and hotel conference facilities.

Office hours are 9am to 5pm Monday to Friday.

How we inspected this service

As part of the preparation for the inspection, we reviewed information provided for us by the service. In addition, we reviewed the information we held on our records regarding this service. During the inspection we utilised a number of methods to support our judgement of the services provided. For example, we spoke with staff, looked at systems and reviewed documents relating to the service.

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 3 August 2021

This service is rated as Good overall. (Previous inspection May 2019 – good overall and in all domains).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive at Sentinel Healthcare South West CIC on 4 June 2019, as part of our inspection programme.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of the provision of diagnostics and screening, minor surgery and the treatment of disease, disorder and injury.

The service was accessible to people who were referred to use it. Some services were provided on behalf of NHS services. For example, diabetic education, support services for GP practices and the facilitation of healthcare apps for patients with long term conditions. Some services were private, for example, minor surgery which is no longer provided on the NHS.

As part of the national emergency response associated with COVID19, Sentinel had been redeployed to run hot hub centres in West Devon in order to provide much needed support to General Practice and the wider health system, and to alleviate the pressure on 999 services.

The service had a registered 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.

We were unable to speak with patients on the day of the inspection but looked at comments received by the service on the activities carried out. All comments were positive.

Our key findings were:

• The service had safety systems and processes in place to keep people safe. There were systems to identify, monitor and manage risks and to learn from incidents.
• There was an effective system for reporting and recording significant events. The service had systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.
• Complaints had been dealt with in line with the regulations.
• Staff told us that their morale was good, that they felt supported by the leadership and involved in decision making at the service.
• Regular team meetings were held and there was an online training system for staff.
• There were systems, processes and practices in place to safeguard patients from abuse.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• Staff treated patients with compassion, respect and kindness and involved them in decisions about their care.
• There was a clear strategy and vision for the service. The leadership and governance arrangements promoted good quality care.
• Procedures were managed safely and there were effective levels of patient support and aftercare advice.
• The service had processes in place to securely share relevant information with others such as the patient’s GP, NHS organisations, safeguarding bodies and private healthcare facilities.
• The service encouraged and valued feedback from patients through internal surveys and a feedback function on their website.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care