The private out-of-hours provider Serco has received another warning from the Care Quality Commission about staffing problems with its service for NHS Cornwall and Isles of Scilly.
The CQC conducted a surprise inspection in December to check on whether previous staffing problems had been addressed at the Truro-based out of hours service. The commission found that there was a shortage of healthcare assistants on duty and Serco did not have enough staff to answer phone calls.
Last year the service was told by the CQC that it had to improve the standard of its services and have a minimum of three GPs per shift. In May 2012 it was found that the OOH service had only one GP on call to cover more than 500,000 people after the other GP was taken ill.
The company made an undertaking to increase the pool of GPs and said it was confident it would be able to meet the needs of the service.
When CQC inspectors made an unannounced visit in December to check on whether action had been taken, they found the service was now compliant with four of the five essential standards for which they had previously been found deficient.
However, the inspection revealed that there were still ongoing staffing problems, with not enough health care advisors (HCAs) employed to handle calls to the service. One in four calls were not being answered within the minimum time of 60 seconds and 12% of ‘urgent’ patients were not having a clinical assessment started within the benchmark time of 20 minutes.
The HCAs said staff shortages meant they had to work under stress and for up to seven hours without a break.
The number of GPs employed by the service had increased since the last inspection but a shift manager said that there were still shortages.
Inspectors found that one car was not covered and a number of clinics in the county had doctors working their shift partly in cars and partly based at a clinic.
There was no GP on duty at the call centre, but Serco said a GP did not necessarily need to be based at the call centre and could be on call. The service said it was now using a ‘wider skill mix’ including nurse advisers and nurse practitioners to provide after hours care, and GPs’ time was used more effectively by having them take telephone calls at their clinics, when call numbers were high.
The CQC says it has told Serco to report by 27 February on what action they will take to meet the standards and the commission will check to make sure that action is taken
A spokesman for Serco said it welcomed CQC inspection report, which it said showed the improvement made over the past months.
‘The CQC … recognised that the number of clinical staff, particularly GPs, employed by the service in Cornwall has increased. They have also said that we need to further increase the number of HCAs in order to meet people’s needs and to meet the specific National Quality Requirement for call handling times and we fully accept this. We have a recruitment campaign under way and will have more advisors on the team by the end of February.
‘All our team in Truro have worked extremely hard to achieve this progress and I have complete confidence that we have everything needed to provide a high quality service for patients in Cornwall in 2013,’ said Dr Louis Warren, who manages the service.
This article has been altered to reflect that the CQC found a shortage of healthcare assistants, and not GPs, in their December inspection as previously stated.