Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Integrated Care 24 Limited – Head Office on 12, 13 & 14 July 2016. The overall rating for the service was good. However we rated the service as requires improvement for providing safe services as we determined that the service must review the arrangements for the management and recording of controlled drugs to make them more effective.

The full comprehensive report on the 12,13 & 14 July 2016 inspection can be found by selecting the ‘all reports’ link for Integrated Care 24 Limited – Head Office on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 7 June 2017 to confirm that the service had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 12, 13 & 14 July 2016. This report covers our findings in relation to those requirements.

Overall the service remains rated as good.

Our key findings were as follows:

• We found that the provider had introduced new standard operating procedures for medicines including controlled drugs (medicines that require extra checks and special storage because of their potential misuse).

• There had been a comprehensive training programme across the provider so that clinicians, drivers and receptionists understood their responsibilities in relation to handling controlled drugs.

• A programme of reporting and audit had been introduced which entailed regular checks of controlled drugs as well as stock checking of medicines.

• A new process had been introduced to help ensure that prescription forms, both computerised and handwritten could be traced through the service to the patient.

At our previous inspection on 12, 13 & 14 July 2016, we identified a breach of the regulations in respect of the arrangements for the management and recording of controlled drugs.

At this inspection we found that the provider had taken action to remedy the issue, consequently the service is rated as good for providing safe services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Integrated Care 24 Limited – Ashford on 12, 13 and 14 July 2016. This is a GP out of hours services which provides health care for urgent medical problems outside normal surgery hours. Overall the service is rated as good.

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

• There was an effective system for reporting and recording significant events. A wide range of events was reported. They were systematically assessed and dealt with.

• Risks to patients were assessed and well managed.

• 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.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Comment cards that patients completed confirmed this finding.

• 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.

• Patients said they found it easy to make an appointment and data showed most patients were seen or contacted in a timely manner. The primary care centres, from which care was delivered, were well equipped to treat patients and meet their needs.

• There was a clear leadership structure. Governance framework was strong. Staff felt supported by management. Independent challenge at board level was welcomed.

• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The service had a systematic approach to working with other organisations to improve care outcomes. For example they had worked with UK Sepsis Trust to develop a protocol to improve diagnosis, safety and care of patients with sepsis (blood poisoning). The protocol was made widely available.

There is one area where the provider must make improvements:

• Review the arrangements for the management and recording of controlled drugs to make them more effective.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice