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Investigation reveals failures in GP out-of-hours services

By Ian Quinn

Demands for a major shake up of GP out-of-hours provision grew today after an investigation showed providers across the country are failing to hit quality targets.

It emerged that only six per cent of local health trusts are assessing out-of-hours calls quickly and safely – with just five out of 83 primary care trusts that responded to a Freedom of Information request saying they carry out clinical assessments within the benchmark period of 20 minutes.

The investigation, showing stark variation in the quality of the assessments, comes as an inquest opened today into the death of 70-year-old kidney patient David Gray, a patient in Cambridgeshire, who received an overdose from German out-of-hours doctor Daniel Ubani, who was on his first shift in Britain.

BBC's Newsnight programme reported huge variation in what proportion of calls to providers were regarded as urgent – ranging from 1 % to 61 %.

The investigation will pile more pressure on the Government to hand back control of out-of-hours to GPs, with the Conservatives already planning to put practices back at the helm and GP leaders currently investigating ways practices could take back responsibility.

It comes during a investigation by the health and social care regulator - the Care Quality Commission - into the quality of out-of-hours services ongoing and follows demands from the RCGP for a major revamp of the system.

A Pulse investigation previously found huge cutbacks by PCTs in OOH cover and GPs had a major lack of faith in current OOH providers.

Meanwhile a consortium of local GPs has been chosen to provide out of hours medical care in Cambridgeshire.

Urgent Care Cambridgeshire, known as Camdoc, was named yesterday as the preferred bidder by NHS Cambridgeshire, following bids by a string of private firms to run the out of hours services across the entire county.

The consortium is already running services in Cambridge City and South Cambridgeshire, as well as taking over the contract for Fenland and East Cambridgeshire from Take Care Now (TCN), the company at the centre of the Ubani case controversy, last month.

Dr Ubani, has since been convicted in Germany of causing Mr Gray's death by negligence and given a suspended prison sentence.

Niall Dickson, head of the General Medical Council, told the BBC he wanted all EU doctors to be tested for competence before they were allowed to practice in the UK.

‘Within the EU there is an assumption that there is an equivalence across the European Union and we are not able to challenge for example whether a particular country's regulator is working effectively or not,' he said.

‘And secondly we're not able to test whether they can speak English or not.'

Watch RCGP champion for urgent and emergency care Dr Agnelo Fernandes discuss out-of hours safety in an exclusive Pulse video interview.

Out of hours care: new report shows huge variation Out of hours care: new report shows huge variation Watch RCGP champion for urgent and emergency care Dr Agnelo Fernandes discuss the safety of OOH care