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CQC warns Serco after out-of-hours service fails to meet essential standards

Private company Serco has been served with a warning notice by the Care Quality Commission after the regulator ruled that the firm's GP out-of-hours service in Cornwall had failed to meet essential health and safety standards, including a shortage of GPs.

The CQC carried out unannounced inspections on the provider in response to concerns relating to eight of its essential health and safety standards. Following the inspection, the CQC failed Serco in four standards, including not providing enough skilled clinical staff. 

The inspections, carried out in April and May this year, also found that Serco failed to safeguard patients from abuse, to ensure staff had sufficient support and training, and that the company had poor practices in place for monitoring the quality of service that people receive.

The ruling comes after a Pulse investigation earlier this year revealed huge gaps in GP out-of-hours cover in parts of the country as providers struggle to recruit staff to fill shifts. 

CQC inspectors found there was a lack of qualified, skilled and experienced staff to meet people's needs and also reported a shortage of clinical staff at times while the provider was in the process of recruiting more GPs.

On the weekend of 21-22 April 2012, inspectors found some doctors working double shifts consisting of 13 hours through the night while others were working 11-hour daytime shifts.

The CQC report said Serco acknowledged it had underestimated demand over the Easter weekend (7-9 April 2012), and that four GP shifts were not covered over the May Bank Holiday, meaning people received a slower service. Among complaints from patients, one person complained of waiting at a clinic for 90 minutes while another gave up waiting for a home visit and dialled 999. 

Serco now has 14 days to report back to the CQC with an action plan to tackle failings. The CQC has the power to restrict or deregister non-compliant services – or, in extreme cases, fine them or even prosecute. 

Ian Biggs, deputy director of the CQC for the south of England, said: ‘At least half a million people depend on this service, so it is vital it is properly staffed with properly qualified GPs who are available when people need them.

‘At times, Serco has not had enough doctors on duty and it is hardly surprising that people have complained. Asking GPs and their drivers to work such long hours should be a last resort. However, we note that the service has already recruited more GPs and has introduced a new triage system to cope more effectively with calls. We haven't found that the company has been deliberately misleading the people of Cornwall about their performance, although quite clearly the system of monitoring performance is unreliable.

‘We now expect Serco to address these issues. The company has 14 days to tell us what they will do to ensure compliance. My inspectors will return at some time in the near future to check that the required improvements have been made, and we will report back on our findings.'

Paul Forden, managing director of Serco's clinical services, said: ‘We acknowledge that at the time of the CQC visit earlier this year, we did not meet all aspects of four standards against which we were being audited. One area was found to be of "minor" concern and three to be of "moderate" concern. We can confirm we have already implemented actions to ensure that three of the four areas have made progress, and we consider we have achieved the required standards. For the fourth recommendation on training, we are 92% compliant today and will fully meet the requirement within the next month. Patient safety and wellbeing is our first priority.'