New Cross Hospital's urgent care centre told to improve - or close

The urgent care centre at Wolverhampton's New Cross Hospital has been placed in special measures by inspectors who found the service to be 'unsafe'.

The centre was given a rating of inadequate after inspectors found it was not safe and well-led. It was also found to be 'requiring improvement' in being effective and responsive to people's needs.

The service will be inspected again in six months time. If it has not improved by then, it could be closed.

The centre opened in April 2016 and is based on the first floor of the hospital's A&E department. It is not run by the Royal Wolverhampton NHS Trust, but by Vocare, which is commissioned by Wolverhampton Clinical Commissioning Group.

The inspection took place on March 21 2017. It found that 'there was the potential risk during the overnight period where children could go long periods without an assessment while the doctor on duty was on home visits'.

The report said that 'some of the nurses were not trained to appropriate levels in paediatrics'. Inspectors also found that 'there was evidence of performance being below the required targets at weekends'. The report continued:

"The systems and processes to address these risks were not implemented well enough to ensure patients were kept safe. We found that safe recruitment procedures were not consistently adhered too.

"Not all safety alerts were acted upon, there was nothing to demonstrate that learning from incidents were shared with staff at a local level and competency checks were not carried out to ensure that staff qualified to care for young children had up to date skills and knowledge."

The provider had not ensured that there were sufficient staff at all times to meet the changing demands of the service.

The report said appropriate arrangements were not in place to ensure the timely and safe assessment and treatment of patients resulting in delays in seeing patients, delays in home visits, delays in seeing children

It also did not have effective systems in place for recording and managing risks in all areas. The service was however given a 'good' rating in being caring. Janet Williamson, deputy chief inspector of general practice and dentistry in CQC’s Central region said:

“NHS 111 and GP Out of hours services are a vital part of the urgent care system which takes pressure away from Accident and Emergency and GP services by allowing people to have easy access to healthcare and advice.

“I am disappointed to see that Vocare is not demonstrating that it can provide the service that patients need. We expect services to demonstrate that they prioritise people with the most urgent needs at times of high demand, and to ensure that care and advice is delivered safely and effectively, and they are referred to the right service as quickly as possible when necessary.

“While we did see aspects of good care provided by committed staff who treated patients courteously and with dignity and respect, we had significant concerns over other aspects of the services.

“Vocare has assured us that they are aware of the issues we have identified and these will be addressed. We will be monitoring the service closely to ensure these improvements continue.

“We will continue to monitor this service and we will inspect again in six months to check whether improvements have been made. I am hopeful that it will do what is required for the sake of their patients, but if we find that it remains Inadequate, we will consider taking further action.”

David Loughton, Chief Executive for The Royal Wolverhampton NHS Trust, added:

“The Royal Wolverhampton NHS Trust always strives to provide high quality, safe care for every patient, every day. The urgent care centre is provided by Vocare and commissioned by the NHS Wolverhampton Clinical Commissioning Group. Whilst the UCC is situated in New Cross Hospital, it is not run by RWT.

"It is important to state that any performance or governance issues about the urgent care centre, bear no reflection whatsoever on the services provided on and off the New Cross site by RWT.

“We are aware Wolverhampton CCG are working with Vocare to address service delivery issues and will monitor the situation closely offer and support as appropriate.”


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