The organisation providing Devon's NHS 111 and out-of-hours GP services has been told to make urgent improvements after a watchdog found patients were at risk, and rated it 'inadequate' overall.

The Care Quality Commission (CQC) found several areas of concern during an inspection of Devon Doctors in July 2020. A follow-up inspection in December found not enough improvements had been made, and the service has now been placed in special measures.

This means that if any of the areas highlighted are still rated 'inadequate' in six months' time, enforcement action will be taken to stop Devon Doctors running the service.

The latest CQC report has been released today (Wednesday, March 17).

It found that patients were at risk of not receiving effective care or treatment.

The failings found by the CQC included understaffing; staff told the inspectors there were times when there were no drivers or clinicians available to make home visits, or staff trained to carry out video consultations.

There were delays in patients receiving treatment.

Call answering targets were not being met and the risks to patients were not being assessed adequately.

There was not always appropriate action to make sure urgent cases were identified and managed as they should be. In some cases, calls were downgraded from 'urgent' to 'routine' by the computer system when transferred from the NHS 111 service to the out-of-hours service, potentially leading to delays in urgently-needed call-backs. This last issue was among those that had been flagged up in the July inspection, but not remedied when the inspectors returned in December.

Problems with leadership and management

The inspection report identified problems with the leadership and operational management of the service. Some staff said they felt senior leaders lacked the knowledge to run a 111 service. There were gaps in staff training and development, and failings in the processes of learning from mistakes, and delays in responding to complaints from patients.

The CQC's overall rating of 'inadequate' was broken down into five sub-headings. On the questions of whether Devon Doctors' services are safe, caring and responsive to people's needs, the organisation was rated 'requires improvement'. On the questions of whether the services are effective and well-led, it was rated inadequate.

However, the report did say that on the whole, staff were kind and caring to patients, and there had been some improvements to performance since the July inspection.

Devon Doctors said it is now working with the CQC, NHS England and other healthcare organisations to tackle the issues raised in the report, and will do whatever it takes to restore the confidence of service users and other stakeholders.

The CQC report can be read in full here