Damning Devon Doctors' assessment

GP out-hours and 111 service must improve urgently

The Care Quality Commission (CQC) has told Devon Doctors of Manaton Court, Exeter that it must improve the service it provides as a matter of urgency. 

Inspectors carried out a focused inspection of the service on 14, 15 and 16 July this year after concerns were raised with the commission. Devon Doctors, which is a limited company, provides what's called an Urgent Integrated Care Service (UICS), including an out of hours GP service and an NHS 111 service, across Somerset and Devon. The service provides a primary medical service to more than a million people, a figure which increases substantially in the summer months due to the area's tourism industry.

During this inspection looked specifically at Devon NHS 111 and out of hours service and some areas of the Somerset out of hours provision.

Janet Ortega, CQC's Head of Inspection for Primary Medical Services in the South, said: “People who call the NHS 111 service are entitled to quick and easy access to healthcare advice and information, or access to urgent attention when that's appropriate. This should never impede on patient care. Our inspectors visited Devon Doctors in July and were not assured that patients were being treated promptly enough and, in some cases, they had not received safe care or treatment. It is clear there are deep rooted issues and the provider needs to address these. 

"We have shared our findings with the leadership team at Devon Doctors and they know what they must do to improve. The provider recognised the concerns highlighted by our inspection team and is working very closely with Devon CCG and Somerset CCG through an improvement programme. 

“We will continue to monitor Devon Doctors extremely closely and will return to inspect services again on an unannounced basis in the near future.”

CQC inspectors found:

• The systems in place to keep patients safe and safeguarded from abuse were not always followed. This meant the risk to patients was not always minimised.
• Not all staff had received up-to-date safeguarding and health and safety training appropriate to their role. Records showed there were gaps in staff completing training and records that had been completed did not show what level of training had been undertaken. Some staff said they were not always confident that the training they had received was sufficient to enable them to carry out their roles. 
• The leadership team was unable to show that actions to address any challenges to the quality of service had been effectively put into place or monitored. Not all staff felt supported by leaders to perform their role effectively. 
• Information to enable staff to deliver safe care and treatment to patients was not always up to date.
• The data relating to performance for the NHS 111 service was consistently considerably below England averages. The service was not achieving the required national targets. Performance targets for answering calls within 60 seconds were not always met and regularly fell below the national average. 
• There were a lack of systems to ensure risks were reduced and the safety of patients’ health and welfare was protected.

A copy of the report is available to read in full here: https://www.cqc.org.uk/location/1-382762170