Updated 4 August 2022
Sheridan Teal House is the base location of the provider, Local Care Direct Limited. Local Care Direct Limited is a social enterprise organisation. It has contractual arrangements with several organisations including clinical commissioning groups (CCG) across West and North Yorkshire and NHS England to provide a range of medical and dental services for up to six million people residing in those areas. These services include:
- West Yorkshire Urgent Care. This is delivered through a contact centre, and 12 primary care centres (PCCs). These services incorporate GP out of hours clinical assessment and treatment, home visiting services, urgent treatment services, and contacting patients out of hours to inform them of pathology results. A daytime clinical assessment service for callers to ‘NHS 111 First’ who have been assessed by NHS 111 as having a one or two hour need to be seen by a GP service or are for services for those under 11 years old is also provided. The commissioning lead is NHS Kirklees CCG and the service operates under the West Yorkshire Urgent Care Contract.
Patients are usually referred to the contracted service via NHS 111. They are then triaged by via a telephone assessment. Patients receive a telephone assessment/consultation and where required are then directed to the most appropriate course of action, such as a face to face consultation or a home visit with a clinician or referral to another, more appropriate service. Patients are also dealt with on a walk-in basis.
There are dedicated vehicles (mobile units), to support home visiting, where a driver transports a clinician to the patient’s address. All vehicles are equipped with a range of medicines and equipment to support the care and treatment of patients as necessary.
Operating under the West Yorkshire Urgent Care contract Local Care Direct also provides ‘Safe Haven’ services for patients in the Calderdale and Kirklees areas who have been deemed unsuitable for mainstream GP services. Patients for this service are supported by a dedicated team of two non-clinical staff and a lead GP. These services formed part of the inspection undertaken by CQC,
- Urgent Treatment Centres. This service operates from two locations and deals with walk-in patients and patients directly booked in by NHS 111. The service deals with minor injuries and ailments. This service formed part of the inspection undertaken by CQC,
- NHS 111 Online Emergency Department Validation (ED). This is a service commissioned by West Yorkshire CCGs under the West Yorkshire Urgent Care contract which validates the ED disposition (when the patient has been advised to attend an Emergency Department) reached by patients using the NHS111 Online tool and for specific groups, offers an urgent care alternative via telephone consultation. Where these patients require face to face treatment, this is provided via booked appointments at an urgent treatment centre or walk-in centre, the out of hours service; or self-care advice. This service formed part of the inspection undertaken by CQC,
- Yorkshire and Humber Dental Clinical Advice and Booking Service. This service is commissioned by NHS England and deals with NHS 111 dental contacts for the whole of Yorkshire and the Humber. The service clinically assesses incoming calls, online requests and those who have been referred into the service. Outcomes for those who contact the service include being given self-care advice and support, direct booking into a dental appointment, or referring on for further medical assessment or signposting to attend an Emergency Department. This service formed part of the inspection undertaken by CQC.
- COVID Medicines Delivery Unit (CMDU). The lead commissioner for the service is NHS Kirklees CCG. The CMDU operates over the West Yorkshire and Harrogate Integrated Care System (West Yorkshire and Harrogate Health and Care Partnership) area. The service identifies patients who are potentially eligible for antiviral treatment for COVID-19. To be eligible patients need to meet specific criteria including being clinically extremely vulnerable. After clinical assessment eligible patients are referred to their local CMDU team who deliver the specific treatment. If a patient is deemed ineligible on assessment, they are given safety netting advice. This service did not form part of the inspection undertaken by CQC.
- Online Consultation GP Support. This service is commissioned by NHS England. It is used to support primary care by providing assessments using e-consultations (a form-based online consultation and triage platform that patients are able to use to contact their GP practice, who then triage the patient from this information and decide on the appropriate care and treatment option). Instead of the assessment being undertaken by the patient’s own GP the Local Care Direct Limited clinical team undertake the assessment and any necessary actions such as treatment or referral to other services. This frees capacity for GPs to see additional patients on a face to face basis. This service did not form part of the inspection undertaken by CQC.
- Urgent Care Rapid Response. This is an early intervention service which began in 2020 and operates within the Kirklees and Calderdale areas. It provides a two-hour response to patients diagnosed as moderately to severely frail in order to prevent admissions or re-admissions to secondary care, by managing the patient at home with appropriate ongoing community response. Referrals received by the team are clinically assessed, and if required patients can be offered primary care appointments via other local providers. Alongside this primary care support, qualifying patients can also access tailored packages of intermediate care or reablement services. This service did not form part of the inspection undertaken by CQC.
- Calderdale Care Homes Video Link. This is a clinical video consultation service where staff in care homes have access to clinical support. Outcomes include patient care advice, the arrangement of home visits, referral or signposting to other more appropriate services. This service did not form part of the inspection undertaken by CQC.
To deliver this wide number of services Local Care Direct Limited employs a range of staff. These include call handlers, reception staff, duty managers, area managers, operational leads, drivers, advanced nurse practitioners and dental specialists. Doctors are engaged on a sessional contractual basis or via an agency.
The provider has appointed organisational leads to support management, governance and oversight of the service, such as a clinical governance lead, a director of clinical governance and quality and an associate director of risk and quality. There is also a chief executive and chief operating officer who report to a board of directors.
In relation to the services delivered by the organisation, the provider is registered with CQC for the following regulated activities:
- Treatment of disease, disorder or injury
- Diagnostic and screening procedures
- Transport services, triage and medical advice provided remotely.