Out of hours GP care unsafe? Print
A watchdog has warned that out-of-hours care must be monitored more closely after carrying out a review prompted by the death of a 70-year-old patient. In its interim report, the Care Quality Commission (CQC) said that a lack of scrutiny meant primary care trusts may fail to spot patient safety issues. David Gray died in February 2008 after a doctor mistakenly gave him an overdose of diamorphine. Before 2004, GPs treated patients during non-office hours, at weekends and bank holidays. But a contract agreed between the British Medical Association and the government in 2004 allowed doctors to opt-out of providing this care. Nine out of 10 GPs opted to accept a salary reduction of £6,000 a year in return for primary care trusts (PCTs) taking on the role of providing cover. Private firms have often provided the treatment under NHS contracts. In June the CQC launched an investigation into Take Care Now, the company providing out-of-hours care in East Cambridge and Fenland when Mr Gray died. CQC chief executive Cynthia Bower said: "Our visits to the five trusts that commission Take Care Now's services showed they are only scratching the surface in terms of how they are routinely monitoring the quality of out-of-hours services. "Although we are still in the early stages of our enquiries, we believe this may point towards a national problem." Take Care Now has since withdrawn 100mg does of diamorphine but concerns over staffing problems and management procedures remain. The health minister, Mike O'Brien, said: "Patient safety is paramount and PCTs have a clear legal responsibility to provide safe, high quality out-of-hours care and are required to have in place robust performance management arrangements to ensure their out-of-hours services are delivering against contractual requirements. "A failure to do so can result in investigation by the independent regulator and enforcement action by primary care trusts where providers are not meeting their contractual obligations." The CQC is due to deliver its final report early in 2010