Lincolnshire Community Health Services NHS Trust provides out-of-hours General Practitioner (GP) services for patients living across Lincolnshire. It is registered to provide the regulated activities of diagnostic and screening procedures and the treatment of disease, disorder or injury.

The out-of-hours service conducted clinical audits that addressed specific areas of patient care. Individual clinicians’ practice was assessed on a regular basis to help ensure that patients received safe and effective care and treatment.

We found the service was effective in meeting patients’ needs and the service was accessible to those who may have mobility issues.

We saw that leaflets to inform patients about how they might raise a complaint were only available in English, but we saw documentary evidence that the Clinical Commissioning Group had instructed that they should not be printed in other languages due to cost. The out-of-hours service had access to language line, which provided a telephone interpretation service. We were told that interpreters could be brought in if necessary. However this was very rare, as most patients either came with someone who could speak English or were able to make themselves understood.

There were systems in place to help ensure patient safety through learning from incidents, the safe management of medicines and infection prevention and control. Following our inspection we raised concerns with the provider with regard to the management of medicines. We received a swift response detailing what action would be taken to address the concerns.

Staff were trained and supported to help them recognise the signs of abuse of children and vulnerable adults and provided staff with training to heighten their awareness of domestic violence.

The provider had not used effective recruitment processes to assess the suitability of staff to work in this sector. We have told the provider they must improve.

Patients experienced care that was delivered by dedicated and caring staff. Patients and carers we spoke with said staff displayed a kind and caring attitude. We observed patients being treated with respect and kindness whilst their dignity and confidentiality was maintained.

The provider had in place business continuity and contingency plans that would enable the service to continue to operate in the event of a failure of, for example, the information technology or telecommunication systems.

We found that the service was well-led and managed by a knowledgeable senior management team and Board of Directors. They had taken action to ensure their values and behaviours were shared by staff through regular engagement.

Members of the staff team we spoke with held positive views of management and their leadership and felt well supported in their roles. They told us the senior managers were approachable and listened to any concerns or suggestions they might have to improve the level of service provided to patients. However, staff did say that it was very rare to see a senior manager at the out-of-hours service due to the hours the service operated.