St Mary Hospital's Urgent Care Centre placed into special measures after damning watchdog report

The Urgent Care Centre (UCC) at St Mary’s Hospital has been placed into Special Measures after health watchdogs rated it inadequate.

The Care Quality Commission (CQC) found “a lack of clear management and clinical leadership” at the unit, which is run by Vocare Limited.

It also said staff did not feel supported in their day-to-day roles at the walk-in centre.

The unit is run by Vocare completely independently of Imperial College Healthcare NHS Trust, which runs the Paddington Hospital and owns the UCC premises.

Vocare said improvements had been made since the inspection and vowed to address issues raised.

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Following the July 2017 inspection, the UCC was rated "inadequate" for being safe, effective and well-led, on Thursday (October 5).

It was rated as "requires improvement" for being caring and "good" for being responsive to people’s needs.

The CQC found opportunities to prevent or minimise harm were missed as there was insufficient oversight and monitoring of ongoing incidents and risks both at local and organisational level.

There was insufficient attention to safeguarding children and vulnerable adults, and the provider had insufficient assurances in place to demonstrate that people received effective care.

Areas where inspectors found Vocare must make improvements include:

Ensuring care and treatment is provided in a safe way to patients
Introduce effective methods to achieve good governance - in accordance with the requirements of the fundamental standards of care
Ensuring sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment
Ensure staff receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties

Recommended improvements include:

Reviewing the fire evacuation procedure to ensure all staff understand what to do in the event of a fire
Review auditory privacy at all points of patient access to the service
Review how patients with a hearing impairment would access the service
Consider providing patient literature in languages aligned to people using the service

Michele Golden, head of general practice inspection in London, said: “We found there had been a lack of clear management and clinical leadership and staff had not felt supported in their day-to-day roles at Vocare Limited’s St Mary’s Urgent Care Centre.”

The Urgent Care Centre was rated inadequate by the CQC and placed into special measures (Image: UGC TMS)

He said the unit wold be inspected again within six months and that “if insufficient improvements have been made, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service.”

Dr Michael Harrison, organisational clinical director of Vocare Ltd, said improvements had been made since the inspection: “The assessment visit took place in July 2017 so we have had over 10 weeks to put in place a clear plan of action designed to address the CQC’s concerns. In most cases, new systems, processes and procedures have already been introduced with the final few measures coming online imminently."

'Patient safety has not been compromised'

He added: “We are confident that we have addressed all concerns raised and that patient safety has not been compromised and will continue to work proactively with our local commissioners to ensure high levels of continuous improvement.”

A spokesman for the hospital trust said: “We’re disappointed that the Urgent Care Centre has had to be placed in special measures by the CQC following their inspection of the Vocare-run service in July 2017.

“We will continue to work with all partners involved in delivering the Urgent Care Service at St Mary’s to help them address these urgent concerns.”

The provision of the Urgent Care Centre was awarded to London Doctors Urgent Care, part of Vocare Limited, by Central London CCG in April 2016 following a competitive tender process.