Urgent care clinic at St Mary's has made big improvements since criticism from watchdogs

A 24-hour urgent care clinic in West London has been lifted out of special measures by the care watchdog, which noted it had achieved vast improvements after its services had been rated 'inadequate.'

The authorities running St Mary's Urgent Care Centre in Paddington welcomed the change in its status to 'requires improvement.'

The Care Quality Commission (CQC) found the clinic had made significant changes since it was criticised by the watchdog following an inspection last July.

It achieved higher grades against the CQC's key inspection themes, including 'good' marks for safety, caring services, and responsiveness to people's needs.

The inspector's report said staff were kind and compassionate, and the centre had made significant leaps in improving its safety processes.

However, the inspector added that the centre still needs to establish better governance processes for maintaining standards of care, and improve oversight of its significant incident reporting processes.

It was also told it should be referring patients to accident and emergency departments faster.

The CQC's report said the centre was not meeting the target of 90 per cent on re-directs from its clinic to A&E in under two hours.

Data for this January and February showed 40 per cent and 52 per cent respectively had been redirected to A&E in less than two hours.

A spokesperson for the Central London Clinical Commissioning Group (CLCCG) said late re-directs from urgent clinics to emergency departments was "an area that many hospital sites find challenging."

"The 90 per cent target is considered an aspirational 'stretch' target for the St Mary's UCC, and is above the current performance levels of other local Urgent Care Centres."

The centre is run by London Doctors Urgent Care, part of Vocare Ltd, which runs after-hours healthcare services for the NHS around England.

It was contracted to provide the urgent care service at the centre, part of St Mary's, an Imperial College Healthcare NHS Trust-run hospital, by the CLCCG in 2016.

Imperial's hospitals, St Mary's and Charing Cross, are both undergoing significant A&E transformations.

Like many hospitals in the UK, both weathered the 'winter crisis' that brought significant pressure on emergency services, and both face targets from NHS Improvement to speed up A&E waiting times this financial year, or miss out on extra funding.

The CLCCG said the urgent centre had improved its performance "significantly" in recent months through joint work to improve clinical processes between Vocare and Imperial NHS.

They had audited 8000 cases to determine why people were being transferred late to A&E, and consequently made changes to decision-making protocols in high priority areas; such as people presenting with symptoms of abdominal pain and chest pain, the CLCCG said.

In April 2018, 50 people were transferred after two hours to A&E- fewer than two people a day, it said.

The CLCCG also noted that since the report had highlighted an overuse of temporary agency staff last year, they had managed to boost the centre's proportion of permanent staff to 72 per cent.

Around 90 per cent of agency staff the centre used were regular workers, and had received the equivalent training given to permanent staff, it said, adding recruitment issues were "common challenges for all front-line services."

The CLCCG welcomed the ratings upgrade, but said they were working constantly to improve.

"Although this report takes the service out of 'special measures', CLCCG and Vocare recognise further improvements to the service are needed, and we will continue to work together to address the issues highlighted in the report."

A Trust spokesperson said Imperial NHS was pleased to see improvements had been made at the centre.