Headlines: October 2nd, 2009

The Care Quality Commission is warning that Primary Care Trusts may not be monitoring performance of GP out-of-hours services effectively and that there is a risk they will fail to spot patient safety concerns. In a report today it says early observations from an enquiry into out-of-hours provider, Take Care, may indicate there is a nationwide gap in monitoring.

The Commission is warning the NHS it must improve its monitoring following visits to the five PCTs that commission out-of-hours services from Take Care Now. While the trusts monitor response times they do not consistently or routinely look at the quality of care. That, says the Commission, could lead to potential problems and signs of poor care being missed. The review follows the case of a patient treated by an out-of-hours locum doctor from Germany who died after being given 100mg of diamorphine.

The Commission found that monitoring varied across the five trusts and now believes this problem might be more widespread. It is concerned that trusts across the country may not be monitoring out-of-hours services closely enough. In addition to response times, it says, trusts should be looking in detail at the quality of clinical decisions, the efficiency of call handling, staffing and doctors’ training.

Cynthia Bower, the Commission’s chief executive, said, “GP out-of-hours services provide vital quality care to people outside of normal surgery hours. As commissioners of these services, PCTs need to ensure people receive safe, quality care around the clock. “

The Commission, which will produce a final report on out-of-hours services next year, has relayed its findings to the Department of Health which is writing to all PCTs asking them to review their monitoring arrangements.