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Independents' Day

GP-led OOH providers beat firms and PCTs for quality

By Steve Nowottny

Exclusive: Not-for-profit GP providers are providing significantly better out-of-hours cover than their privately-owned or PCT rivals, Pulse can reveal.

A detailed analysis of Healthcare Commission figures - combined with data obtained by Pulse under the Freedom of Information Act - provides the first official confirmation that GP-led cover is superior to other models.

The analysis is likely to pile further pressure on ministers to consider handing back responsibility for commissioning out-of-hours care to GPs.

Pulse revealed last month that the Department of Health had begun discussing moves to hand practice-based commissioning groups across the country the power to run out-of-hours services.

As part of its first report into urgent and emergency care in England, published last week, the Healthcare Commission scored out-of-hours providers on seven key areas, including phone answering, provision of medication and quality assurance.

Trusts received an average score of 21.8 for out-of-hours care. But Pulse's analysis of the figures, combined with FOI data from 110 PCTs, reveals that the type of provider was an important influence on quality.

Trusts with not-for-profit providers scored 24.0 and those where GPs ran services directly 23.4, compared with 19.9 for PCT-led provider arms and 21.7 for private providers.

Dr Simon Abrams, medical director of the Urgent Health UK consortium, which represents five of the country's largest not-for-profit providers covering more than 5 million patients, said the findings showed the benefits of ‘business methods for community gains'.

‘We don't have a profit focus,' he said. ‘We have to be solvent, we have to be viable, but we're not answerable to our shareholders.

‘We're also able to focus very carefully on out-of-hours. We have fewer distractions than perhaps PCT organisations might have. They're obviously having to provide a much broader range of services.'

Chris Wright, chief executive of Devon Doctors, said the not-for-profit provider – which was one of the top-performing services in the country - was part-owned by all 176 practices in Devon.

‘Not for profit is something which seems to appeal to a lot of GP practices, and that helps integrate them into our services,' he said. ‘The advantage of that is it helps smooth out the differences between in-hours and out-of-hours care.'

The Healthcare Commission's wide-ranging review of urgent and emergency care found there had been ‘significant improvements' from many providers – but also warned there remain major gaps in out-of-hours cover.

Some 30% of services are failing to meet national requirements on answering telephone calls, while 35% are missing targets on how quickly they start assessments following a patient's initial call.

GP-led OOH firms beat PCTs and firms on quality

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