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14 May 2015, 18:18
A GP out-of-hours service in Leicestershire has been placed in special measures after inspectors found patients were at risk of harm and waiting too long to be seen with urgent problems.
Essential medical equipment at Leicester City, Leicestershire and Rutland Out-of-Hours (LLR) service was found to be out of date or unavailable, while there was "insufficient assurance to demonstrate people received effective care and treatment'', the Care Quality Commission (CQC) said.
It rated the service "inadequate'' in four out of five categories, while the fifth, which evaluates how caring staff are, was deemed as "requires improvement''.
LLR provides services to nearly a million patients when GP practices are closed during the night, at weekends and on public holidays, according to its website.
The CQC found patients were at risk of harm ``because systems and processes were not in place to keep them safe'', with emergency and urgent patients not "seen for face-to-face consultations in relation to their medical needs and in a timely manner''.
A lack of appropriate equipment caused delays in treating some patients, and medication management was poor with medicines found to be out of date, inspections carried out in March discovered.
The provider employs more than 250 GPs, nurses, health care assistants and support staff, but many were found to be unclear about reporting incidents, near misses and concerns, and there was "no evidence'' of learning and communication.
There was also no clear leadership structure and limited formal governance arrangements.
The CQC said it was working closely with NHS England and the three Leicester, Leicestershire and Rutland clinical commissioning groups to support the service while it addresses the issues identified.
Janet Williamson, deputy chief inspector of general practice and dentistry in the CQC's Central region, said: "It is important that the people who use Leicester City, Leicestershire and Rutland Out-of-Hours service rely on getting the high quality care which everyone is entitled to receive.
"GP out-of-hours services face particular challenges in providing safe, compassionate care. Patients are often unfamiliar to staff, and staff do not always have access to their medical records.
"Often these services have a large workforce where staff may not know each other well. Cases can be complex and urgent and must be handled effectively in order to ensure the best patient care is delivered.
"Although the patients we met told us they were treated with dignity and respect, we also found that care and treatment was not always delivered in line with best practice.
``We know that Leicester City, Leicestershire and Rutland Out-of-Hours has acknowledged the areas where action must be taken. We have found significant areas of concern, which is why we are placing the service into special measures - so opening the way to support from NHS England among others.
"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 the service will do what is required for the sake of its patients, but if we find that the service remains inadequate, we will consider taking further action.''
A spokesman for Leicestershire clinical commissioning groups (CCGs) said: "We have welcomed immediate recognition and agreement between all concerned that required improvements and a detailed action plan must be delivered by Central Nottinghamshire Clinical Services (CNCS) as a priority and the CCGs continue to fully support them in doing so.
"A number of improvements have already been delivered by CNCS as early outcomes from this action plan.
"We will continue to work closely with all concerned to ensure the complete delivery of the full agreed action plan and to assure that all required improvements are delivered.''