THE flagship i-HEART Barnsley service which aims to give patients better access to GPs has been slammed by health bosses who said people were at ‘serious risk of receiving unsafe care or treatment’.
i-HEART was launched in 2015 by Barnsley Healthcare Federation and offers extended hours to GP services; an out of hours service which offers home visits and telephone advice through NHS 111, and a walk-in service at Barnsley Hospital.
But in its first inspection by the Care Quality Commission in February, inspectors rated it inadequate across the board with the exception of being caring.
It was placed in ‘special measures’ and will inspected again within six months.
A report said there had been a serious incident in which a patient had died, but the federation had not issued revised guidance, or identified and delivered specific training to staff to prevent such an incident happening again.
In addition, the death did not trigger any review of clinical skills, competencies or judgements made by clinicians.
The federation was asked to immediately address the failings which led to the incident, and ensure all staff were appropriately skilled, competent and trained.
The report went on to say that following another incident, this time where potentially fatal sepsis was not recognised, staff received no updated guidance or protocols, only an e-mail warning them to be vigilant about patients who may present with sepsis. Staff had not been routinely trained in diagnosing or treating sepsis.
A patient record showed one person had not been prescribed an appropriate course of antibiotics for treatment of tonsillitis.
From September 2017, when i-HEART was registered with the CQC, inspectors saw six significant events had been documented, but lessons were not analysed or shared and action was not being taken to improve safety.
Some other areas of concern were:
- Unsafe telephone triage process
- Inability to demonstrate it ensured care and treatment was delivered according to guidelines
- Poor recording in patient records
- Could not demonstrate an effective process for assessing patients
- Processes not in place to demonstrate staff had the skills, knowledge and experience to carry out their roles
- Complaints not being dealt with properly.
However, inspectors found staff involved patients in their care, and treated people with compassion, kindness, dignity and respect. Patient said they felt they were listened to and supported.
In response to the CQC findings, an extensive review of all operational areas within i-HEART and across the federation has resulted in significant changes to staff recruitment, training and checks, recording and management of patient feedback, triage systems used, sepsis management and clinical governance, a spokesman said.
Federation chief executive Marie Hoyle said: “i-HEART is a service unique to Barnsley. It was borne out of a need to rethink the way in which our GP services are delivered, providing opportunities for patients to access same day appointments at times when GP surgeries are typically closed. Since it launched, i-HEART has helped thousands of people across Barnsley.
“Whilst we are disappointed with the inspection’s findings, our priority has been to address concerns which were raised work which began immediately.
“The service which operates today is very different to the one which was inspected by the CQC.”
Medical director Dr David Shutt said: “Whilst the inspector’s findings make for difficult reading, the measures we have implemented have resulted in significant changes to the way in which i-HEART operates.”
Barnsley Central MP Dan Jarvis said:
“Local people deserve better and it is simply unacceptable that patients have been at serious risk of receiving unsafe care or treatment.
“Whilst I welcome the action that iHeart have taken to address current failings, I will be raising my concerns with Barnsley Healthcare Federation and Barnsley CCG.”
A spokesman for Barnsley Clinical Commissioning Group, which commissions i-HEART, said: “We are confident that Barnsley Healthcare Federation has a comprehensive plan for all of the areas noted by the CQC report and we have already seen much of that work take place since the inspection.
“The report highlights that patients say they feel listened to and supported by staff. We welcome the follow-up inspection in the next few months to ensure improvements have continued.”
