OUT-OF-HOURS medical care across Somerset has been rated as "inadequate" in its latest inspection. 

The Care Quality Commission has told Vocare, also known as Somerset Doctors Urgent Care, to make improvements to its NHS 111 service and its GP Out of Hours (OOH) servive. 

CQC carried out this announced comprehensive inspection of Vocare’s service at Wellington House, Taunton, on 24 and 25 April 2017. 

The GP OOH service has now been placed into special measures after it was rated as "inadequate" for safety, effectiveness, and being well led, and "requires improvement" for being responsive to people’s needs and "good" for being caring.

In a separate inspection, the NHS 111 service was rated as "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.

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."

But Somerset Clinical Commissioning Group is assuring the county that the service is safe to use. 

Sandra Corry, Somerset CCG’s director of quality and patient safety, said: “Somerset Clinical Commissioning Group (CCG) is disappointed with the findings of today’s Care Quality Commission (CQC) and is aware of concerns by some patients regarding long delays after calling the GP out-of-hours urgent care service (known as Somerset Doctors Urgent Care) after they had called the NHS 111 number.

“Somerset Clinical Commissioning Group (CCG) is working closely with the Care Quality Commission, NHS England and Vocare Ltd to ensure Vocare deliver the operational improvements needed to their organisation’s systems and in line with their agreed action plan.

“Members of the public should understand that the NHS 111 health helpline is continues to be number to call if they or a family member become ill overnight or require access to an out of hours medical care.  

“If their health condition significantly worsens after they have called NHS 111 they should call NHS 111 again and let them know. 

“If members of the public believe they are experiencing a medical emergency then they should telephone 999 for an ambulance.

“For minor illness or ailments members of the public can help themselves and their local NHS with self-care, seeking advice from a community pharmacist, or by making appointment with their GP Practice.”

In the GP Out of Hours service CQC has told Vocare that it must make a number of improvements 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. This includes 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. 
  • Serious incidents, deaths or safeguarding referrals are subject to statutory notifications to the Care Quality Commission. 

For the NHS111 service CQC has told Vocare that it must make a number of improvements 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. 
  • Staff must have regular call auditing, including clinician consultations, in line with Vocare policy.