Practice Plus Group - East of England

Updated 22 May 2017

Care UK – East of England out-of-hours service provides out-of-hours primary care services for Suffolk. The head office is located in Ipswich, Suffolk. The GP out-of-hours service is run from eight primary care centres across the county. All eight locations are open at weekends, and five are open during the week. The service operates from eight primary care centres at the following times:

• West Suffolk Hospital, Bury St Edmunds: 6.30pm to 8am daily.
• Ipswich Hospital, Ipswich: 6.30pm to 8am daily.
• Haverhill Health Clinic, Haverhill: 10am to 9pm on Saturdays, and 11am to 9pm on Sundays.
• Mildenhall Health Centre, Mildenhall: 11am to 8pm on Saturdays.
• Saxmundham Health Centre, Saxmundham: 7.30pm to 11.30pm Monday to Friday, and 8am to 8pm on Saturdays and Sundays.
• Stowhealth, Stowmarket: 7pm to 11pm Monday to Friday, 2pm to 11pm on Saturdays and 2pm to 10pm on Sundays.
• Sudbury Community Health Centre, Sudbury: 7pm to 12am Monday to Friday, 9am to 11pm on Saturdays and 10am to 10pm on Sundays.
• Hartismere Hospital, Eye: 3pm to 8pm on Saturdays.

The type of consultation offered is dependent on circumstances and the outcome of an initial triage call. In some instances appointments can be directly booked with the out of hours service by the NHS 111 service who are the first point of contact.

The service employs 102 staff members, and 88% of these have direct patient contact.

The service covers over 1,500 square miles and just under 750,000 patients. Suffolk is one of the most rural counties in England and has a transient population over the summer months. There are mixed levels of deprivation throughout the county. 23% of the population are aged over 65.

The Suffolk Dental Out of Hours Service provides treatment for patients who require an urgent dental appointment at weekends and bank holidays. This service is provided in Suffolk by Care UK and covers Ipswich and East Suffolk and West Suffolk. The service does not offer walk-in appointments and access to the service is via the national NHS 111 call line. The NHS 111 team assess patients who may then be referred for a face to face appointment with a dentist or a telephone consultation.

The dental services are provided out of a purpose adapted dental van at weekends and bank holidays from Ipswich Hospital between 10am and 1pm. The van then travels to Bury St Edmunds to see patients from 2.30pm to 4.30pm.

The out of hours dental services are provided by a team of eight dentists, four dental nurses, one receptionist and one driver who work on a part time basis.

Updated 22 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Care UK – East of England on 28 February 2017. The service provides out-of-hours GP and dental services. Overall the service is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for recording, reporting and learning from significant events.
• Learning from significant events was cascaded nationally throughout the organisation. The organisation sent out a national quarterly clinical newsletter in which several similar significant events were shared and discussed. For example we saw a newsletter in which, amongst several other significant event analyses, three different presentations of a pulmonary embolism (blood clot on the lungs) were described, with questions posed to the reader, these had all been raised as significant events from different services within the organisation.
• Risks to patients were assessed and well managed.
• Patients’ care needs were assessed and delivered in a timely way according to need. The service met the National Quality Requirements.
• 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.
• The service maintained appropriate standards of cleanliness and hygiene. For example, the dental van was visibly clean and clutter free. Infection control practices were followed, reviewed and audited to test their effectiveness.
• There was a system in place that enabled staff access to patient records, and the out-of-hours staff provided the local GP and hospital, with information following contact with patients when appropriate.
• The service managed patients’ care and treatment in a timely way.
• Patient feedback was strongly and consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
• 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 and complied with the requirements of the duty of candour.

We saw several areas of outstanding service:

• There was a strong focus on continuous learning and improvement at all levels. The provider had made use of an external contractor who had been given an open brief to seek and devise development opportunities into elements of service delivery in the out-of-hours.
• The provider proactively sought patients’ and staff feedback and engaged patients in the delivery of the service. For example, in the primary care centres there were posters in the waiting areas that encouraged patients to comment on the services provided. The provider conducted surveys of patients’ experience on an ongoing basis. In January 2017, 255 patients had responded to surveys and 99% had expressed overall satisfaction with the service they had received. The trends in feedback were closely monitored, and the results illustrated an upward trend from the February 2016 overall satisfaction score of 88%.
• The provider had created an in-house learning mobile app for staff to use on their phones and handheld tablet devices. This had led to a high uptake of training courses for all staff within the organisation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice