CQC find significant improvements required at Vocare, Somerset

The Care Quality Commission (CQC) has told Vocare that it must make improvements following recent inspections.

CQC carried out a comprehensive inspection of Vocare, known locally as Somerset Doctors Urgent Care, in April. It has told Vocare it must make improvements to its NHS 111 service and its GP Out of Hours service.

The GP Out of Hours service has been rated ‘inadequate’ and placed into special measures. It was rated ‘inadequate’ for being safe, effective and well led, ‘requires improvement’ for being responsive to people’s needs and ‘good’ for being caring.

In a separate inspection, the NHS 111 service was rated ‘requires improvement’ overall. It was rated as ‘inadequate’ for being well led, ‘requires improvement’ for being safe and effective, and ‘good’ for being caring and responsive to people’s needs.

The CQC has told Vocare that it must make a number of improvements to its GP Out of Hours service, including ensuring: there are robust and effective systems and processes to monitor and improve the quality and safety of the services and mitigate risks relating to the health, safety and welfare of service users - including staff training, recruitment processes, and management of medicines; there are adequate staffing levels in place to provide timely access to the service for all patients including providing reassurance where there are long waits for a response; complaints and significant events are dealt with consistently with clear explanations of actions taken and the identification of learning or sharing of learning; and serious incidents, deaths or safeguarding referrals are subject to statutory notifications to the CQC.

The CQC has also told Vocare to make a number of improvements to its NHS 111 service, including ensuring: there are robust and effective systems and processes in place to assess, monitor and improve the quality and safety of the services provided and mitigate risks relating to the health, safety and welfare of service users; there are adequate professional employment checks for all staff before employment commences; there is an accessible and organised system for oversight of risk assessments and safety checks and access to emergency equipment such as first aid and fire safety equipment; and staff must have regular call auditing, including clinician consultations, in line with Vocare policy.

Ruth Rankine, Deputy Chief Inspector of General Practice, 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. While the NHS 111 service is rated as Requires Improvement. we have placed the GP Out of Hours service into special measures.

“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.”