CQC keeps Vocare out-of-hours service in special measures

The Care Quality Commission has told troubled provider Vocare that it must make further improvements to its NHS 111 service and its GP Out of Hours service, following a recent re-inspection.

Vocare, known locally as Somerset Doctors Urgent Care (part of the Vocare Group) was first put into special measures in April this year.

The Care Quality Commission said the “inadequate” service run by private company Vocare was unsafe, ineffective and poorly led.

“Our levels of concern following this inspection were significant and we placed the provider into special measures,” the report published 16 November stated.

The follow-up inspection was carried out on 24 August, 2017 relating to the progress against two Warning Notices which had been previously issued, this included the governance of the service to reduce/ eliminate the risks to patients.

The CQC has told the provider that it must make further improvements to its services or it could face suspension.

Being placed into special measures represents a decision by CQC that a service has to improve within six months to avoid the regulator taking steps to cancel the provider’s registration.

Ruth Rankine, deputy chief inspector of General Practice said she is disappointed to see that Vocare “are still not demonstrating that it can provide the service that patients need.”

“We have issued a further four warning notices to ensure significant improvements are taking place and will continue to monitor the services,” Rankine said.

“Services need to demonstrate that they are ensuring people with the most urgent needs are prioritised 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.”

She said, however, they are aware that there have been many changes within the operational structure of Vocare and did see aspects of good care during their inspection provided by committed staff who treated patients courteously and with dignity and respect.

Vocare told the CQC it now has oversight of the issues “and are making the improvements necessary.”

The latter investigation revealed [some] concerns relating to the warning notices were rectified, such as around emergency medicines and calibration of clinical equipment, however with regard to medicine management, it remained inadequate.

Rankine said they will continue to work closely with their stakeholders including Somerset CCG to monitor and inspect the service to ensure that improvements are put in place.

Vocare said it was working closely with Somerset’s CCG to deliver “the level of services required across Somerset”.

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CQC has told Vocare that it must make improvements including ensuring:

• care and treatment is provided in a safe way to patients
• effective systems and processes are established to ensure good governance in accordance with the fundamental standards of care
• sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment

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Two weeks ago, the Somerset CCG said it had considered cancelling its contract with Vocare, branding the out-of-hours GP services as “unacceptable”.

Derek Prentice, from the Royal College of Emergency Medicine, told the BBC: “I’m appalled but I’m afraid I’m not surprised.

“It’s becoming an all too common story around the country when services that have been privatised fail and then other NHS services have to pick up the remnants of that and try to provide the kind of care and attention that patients come to expect.”

Vocare remains under special measures until the CQC carries out a further investigation and publishes the findings “in due course.”