The Care Quality Commission
  • Doctor
  • Urgent care service or mobile doctor

Northwick Park Hospital Urgent Care Centre

Overall: Good read more about inspection ratings

Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ (020) 8869 3445

Provided and run by:
Greenbrook Healthcare (Hounslow) Limited

All Inspections

2, 3 and 9 August 2022

During a routine inspection

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection of Northwick Park Hospital Urgent Care Centre on 2, 3 and 9 August 2022. The service had previously been inspected in October 2018 where it had been rated as good overall, and in all five key questions.

The registered manager is the Head of Quality and Governance at the location. 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.

Our key findings were:

  • The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The service was not meeting targets for streaming patients as required by its commissioners. In particular, streaming times at the Northwick Park site were outside of levels defined as safe by national targets.
  • The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the service easy to access and reported that they were able to access care when they needed it. However, the service was not ensuring a throughput of patients in line with its four-hour target.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure that care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

  • Improve throughput times such that it meets targets for discharging patients in four hours.
  • Review how to improve the lack of compatibility between the UTC and Emergency Department computer systems.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

During a routine inspection

This service is rated as Good overall. (Previous inspection September 2016 – Requires improvement)

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 inspection at Northwick Park Hospital Urgent Care Centre on 31 October 2018, as part of our inspection programme, to follow up on breaches of regulations identified during an announced inspection carried out the 14 September 2016 to check whether the practice had carried out their plan to address the requirements.

The previous issues were;

  • Not all staff undertaken safeguarding, basic life support, infection control, fire safety and information governance training relevant to their role.
  • Not all staff had received an appraisal in the last year.
  • There were inadequate systems in place to monitor the implementation of medicines and safety alerts.
  • Service users are always treated with privacy and dignity.
  • There were no arrangements for service users who had a hearing impairment or needed translation services.
  • Staff had limited knowledge of and involvement in the vision and strategy of the service.
  • The service needed to improve joint working between the management team of the Urgent Care Centre (UCC) and the Emergency Department (ED) and improve communication within the management team.

At this inspection we found:

  • 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 liaised with and had regular meetings with the Emergency Department (ED) and the management team.
  • The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
  • The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • The service understood the needs of the changing local population, increased demand on local health services and had planned services to meet those needs.
  • Patients’ care needs were assessed and delivered in a timely way according to need and in line with current evidence based guidance.
  • Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
  • The service had an effective streaming pathway in place; children under two years were triaged by a GP within 15 minutes of arrival and patients requiring urgent care are usually seen within 20 minutes by a member of the nursing team.
  • All staff received up-to-date safeguarding and safety training appropriate to their role. They knew how to identify and report concerns.
  • 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.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

14 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northwick Park Urgent Care Centre on 14 September 2016. Overall, the service is rated as Requires Improvement.

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

  • Risks to patients who used services were assessed and well managed.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events; however significant events are not formally discussed with all staff.
  • There were systems and processes in place to keep patients safe and safeguarded from abuse; however not all staff had undertaken safeguarding training relevant to their role.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment; however, we observed that clinicians did not always maintain patients’ dignity and confidentiality.
  • Information about services available for patients was limited and was not easily accessible to service users. The service had no hearing loop to help patients with hearing impairments and translation services were not widely advertised for patients.
  • The service understood the needs of the changing local population, increased demand on local health services and had planned services to meet those needs.
  • Patients’ care needs were assessed and delivered in a timely way according to need and in line with current evidence based guidance.
  • Appraisals for many clinical staff were overdue and not all staff had undertaken basic life support, infection control, fire safety and information governance training relevant to their role.
  • The service had an effective streaming pathway in place; children under two years were triaged by a GP within 15 minutes of arrival and urgent patients were usually seen within 15 minutes of arrival by an emergency nurse practitioner. This pathway also ensured that all patients with life threatening conditions received the most appropriate response.
  • There was a system in place that enabled staff access to patient records. The information provided to the GPs following contact with patients was appropriate.
  • Information about services and how to complain was available. 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 a vision and a strategy but not all staff were aware of this and their responsibilities in relation to it. Service specific policies were implemented and were available to all staff; however, we were not assured that all staff were aware of these policies.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • Ensure all staff undertake safeguarding, basic life support, infection control, fire safety and information governance training relevant to their role.
  • Ensure regular appraisals are undertaken for all members of staff.

In addition, the provider should:

  • Review systems in place to ensure there is a clear system in place to monitor the implementation of medicines and safety alerts.
  • Ensure service users are always treated with privacy and dignity.
  • Consider improving communication with patients who have a hearing impairment and ensure translation services were made available for service users.
  • Improve staff knowledge of and involvement in the vision and strategy of the service.
  • Consider improving joint working between the management team of the Urgent Care Centre (UCC) and the Emergency Department (ED) and improve communication within the management team.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice