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Independents' Day

Private OOH provider told to have at least three GPs on duty

A private out-of-hours provider recently warned by the Care Quality Commission over the standards of its service has been told it must have a minimum of three GPs per shift after concerns were raised about a shortage of staff.

Serco, which runs the out-of-hours service for NHS Cornwall and Isles of Scilly, also faces the possibility of having its contract altered to stipulate a minimum number of staff per shift, after GP commissioners raised concerns about the service.

The firm was served with a warning notice by the CQC in July after the regulator ruled that the service in Cornwall had failed to meet essential health and safety standards, including not having enough GPs on call.

Concerns were voiced after it emerged that just one GP covered more than 500,000 people on 29 May after another GP had been taken ill.

The new staffing stipulation was made after the PCT held two clinical meetings – chaired by a GP leader from Kernow CCG – following the night of 29 May.

Bridget Sampson, director of primary care for NHS Cornwall and Isles of Scilly, told Pulse the incident had caused it to make an agreement with Serco specifying they must have a minimum of three GPs on shift at any time, and provide the trust with shift rotas in advance as part of the additional assurance.

She said: ‘At the moment, this is a voluntary undertaking by Serco, but one that we may seek to formalise and embed in its current contract in due course.

‘Any failure to meet contractual obligations can result in it being served with a remedial notice, but we are assured that there is a clear commitment from Serco to rectify the recent problems and we are supporting them in doing so.’

A spokesperson for Serco said: ‘There have been at least two GPs on call every night since June 2011, with the one exception of 29 May when unfortunately there was only one on call due to illness. We have increased the pool of GPs and we are confident we are now well resourced to meet the needs of the service and our track record clearly demonstrates this.’

Dr Peter Merrin, chair of Cornwall and Isles of Scilly LMC, said the recommendations were ‘sensible’. He said: ‘It is encouraging that both the recent CQC evaluation and an independent local report have acknowledged these issues and made sensible recommendations. It is particularly pleasing that Serco has taken steps to resolve some of the shortcomings regarding staffing of the service.’

Readers' comments (8)

  • Vinci Ho

    Having previously worked in OOH for over 10 years, I have a soft spot and sympathy on OOH providers(whether private or GP cooperatives) , in recruitment difficulties.
    OOH is itself a different specialty . You work in unfriendly hours of the day when medical options are less . You have to stick to safe practice still . The pay is not attractive especially under current atmosphere of recession and pay freezes . Morale in OOH can be even lower (not to mention the forthcoming devil of 111) . Day time GPs are already exhausted with all these NHS changes and really cannot spare more hours for OOH . Recruitment of doctors ,who can work consistently in same sessions week in week out ,is very difficult . I have full respect to those who can still manage to do so. They do not normally have much credits anyway.
    Then you have desparate providers recruiting doctors from abroad and we end up with doctor with poorer English who gave patients a lethal dose of morphine.
    For those who know a bit about the history , many years ago it was medical students being recruited to do OOH work when rules were very lax those days . Of course, that cannot happen today but it just shows unpopular as a job it is..........

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  • I have little sympathy for these providers. They took the contract on a commercial basis, hoping to make a profit. If you can't get enough bums on seats, you need to increase the pay you're offering. I've never understood why OOH is paid at less than standard daytime locum rates!

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  • Perhaps there is a need to look at commissioning contracts too? OOH can only pay out within a contractual buget, there is no profit element. It is not just the commercial providers, all providers are effected in this climate. There is an ever strong desire to deliver quality care under a more demanding remit.

    Regardless of pay, how many in the GP world can work overnights when in practice the following day? Appropriate contracts to attract the appropriate funding to attract the calibre of GPs is not available. Coupled with the extremely low levels of overnight calls in an efficiency drive, the cost of multiple professionals to deal with a handful of calls is frowned upon.

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  • For a GP earning a taxable £100,000 pa, the addition of£16,000 pa working out of hours adds £5,600 pa to their income due to the excessive tax rate of 65% caused by the loss of basic allowance.
    At about £220 for a 6 hour session, and say one hour in total for travelling it means that the take home pay is little more than £10 an hour.
    No wonder recruitment is difficult!

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  • I agree with the above - but you forgot the increased MPS/MDU rates for OOH work and the increased stress of dealing with complaints and errors etc which are much more common in OOH work. Why bother?

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  • £100 an hour minimum should be the going rate!

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  • get what you pay for...

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