Archived: Richmond GP Out of Hours Service Primary Care Centre

Updated 18 August 2017

East Berkshire Primary Care Out Of Hours Services Limited is a not-for-profit social enterprise that provides urgent medical care and advice out-of-hours (OOH) for approximately 400,000 patients in Berkshire, 30,000 in South Buckinghamshire and 250,000 in Richmond and Twickenham from its operational headquarters in Bracknell.

Richmond GP Out of Hours Service is one of the registered locations for the OOH GP service provided by East Berkshire Primary Care Out Of Hours Services Limited. The full address for this location is:

• Richmond GP Out of Hours Service, Outpatients Department, Teddington Memorial Hospital, Hampton Road, Teddington, TW11 0JL.

The administrative base and headquarters for East Berkshire Primary Care Out Of Hours Services Limited is located at Abbey House, Bracknell in Berkshire. Richmond GP Out of Hours Service is situated in rented spaces from the Hounslow and Richmond Community Healthcare Trust and the facilities are managed by the respective organisation.

Richmond GP Out of Hours Service is contracted by the Richmond GP alliance and provides OOH primary medical services to registered patients and those requiring immediately necessary treatment in London Borough of Richmond and the surrounding area when GP practices are closed this includes overnight, during weekends, bank holidays and when GP practices are closed for training. Most patients access the out of hour’s service via the NHS 111 telephone service. Patients may be seen by a clinician, receive a telephone consultation or a home visit, depending on their needs. Occasionally patients access the service as a walk-in patient.

The health of people in London Borough of Richmond is similar when compared with the national averages. For example, 49% of people within London Borough of Richmond have a long-standing health condition, comparable to the national average which is 54%. The higher percentage of people with a long-standing health condition could mean increased demand for GP services including OOH services.

The population of London Borough of Richmond is comparable to the local and national average for the proportion of people aged below 18 and a lower proportion of people aged over 65 compared to the local and national average. Life expectancy for both men and women is similar when compared with the national average.

Updated 18 August 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at East Berkshire Primary Care Out of Hours Services Limited – Richmond GP Out of Hours Service Primary Care Centre on 4 October 2016 found a breach of regulations relating to the safe and well-led delivery of services. The overall rating for the service was requires improvement. Specifically, we found the service to require improvement for the provision of safe and well led services. The service was rated good for providing effective, caring and responsive services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for East Berkshire Primary Care Out of Hours Services Limited on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 5 July 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified in our previous inspection in October 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

We found the service had made improvements since our last inspection. At our inspection on the 5 July 2017 we found the service was meeting the regulations that had previously been breached. We have amended the rating for the service to reflect these changes and improvements. East Berkshire Primary Care Out of Hours Services Limited – Richmond GP Out of Hours Service Primary Care Centre is now rated good for the provision of safe, effective, caring, responsive and well led services. Overall the service is now rated as good.

Our key findings were as follows:

• East Berkshire Primary Care Out of Hours Services had comprehensively reviewed the existing governance framework in place and embedded the current models of best practice across all of the services locations.

• The medicines management team had implemented new processes to ensure that the service actioned all patient safety alerts and MHRA (Medicines and Healthcare Products Regulatory Agency) alerts.

• Prescription stationary was stored securely and tracked through the service at all times; this included when prescriptions were in the out of hours vehicles.

• The service reviewed the Controlled Drug Home Office licence requirements and contacted the Home Office for confirmation and to begin the registration process.

• There was now a designated person specifically to manage quality, ensure improvements were made and sustained. This included consideration of location specific clinical audits to review, monitor and improve outcomes for people accessing care and treatment at the different locations within the service. Furthermore, this included a review of all the feedback and areas of improvement that we reported on following the October 2016 inspections. For example, vehicle equipment checks were completed in line with the service policy and regular infection control checks completed on-site.
• Arrangements to manage training had been strengthened. Specifically, we saw all staff undertaking chaperoning duties, including the drivers of out of hours vehicles, had received appropriate chaperone training. Furthermore, as part of the review of training arrangements a member of staff had been appointed to monitor all training arrangements within the service.
• The service had reviewed and taken steps to improve signage across all five primary care centres to ensure patients visiting each site could access the services without delay.
• Information for patients about the complaints procedure was clearly on display and carried in vehicles for patients receiving care and treatment in their place of residence.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice