GP brands out-of-hours care 'chaotic'

A RETIRED Suffolk GP is calling for a return to the old system of out-of-hours medical care as he claims the current one is “chaotic”.

Naomi Cassidy

A RETIRED Suffolk GP is calling for a return to the old system of out-of-hours medical care as he claims the current one is “chaotic”.

Dr Alec Russell, a GP in Walsham-le-Willows near Bury St Edmunds for 42 years, said recent high profile cases relating to out-of-hours care has caused him to raise the issue with fellow GPs and shadow health secretary Andrew Lansley.

The service is run by Take Care Now (TCN), a private firm based in Ipswich, but it has come under severe scrutiny in recent months after a number of problems.

Dr Russell said: “Listening to people who have had out-of-hours care, it is fairly chaotic. I don't think it is good enough.

“When I was a GP we used to do this service within our practice. It used to work pretty well. Some doctors did not like it but we did it as part of our duty.

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“I was on duty on Monday nights and the likelihood was you would get one call-out a night. There is no continuity now as the doctor who comes to see you is a complete stranger.

“What I would like to see is doctors taking back some responsibility. I'm of a different generation but I know this is not a pipe dream. It is about trying to persuade doctors to do it.”

In 2004 the GP contract allowed doctors to opt out of their commitment to out-of-hours service in return for a pay cut.

Primary care trusts were given the responsibility to commission these services - at which point TCN won the contract to cover Suffolk and four other counties. That contract expires in March 2010 and NHS Suffolk will then have to decide who provides the out-of-hours care after that time.

Earlier this month, safety concerns were raised about the current system in an official report.

The Care Quality Commission had launched a probe after the death in February last year of 70-year-old David Gray, who was accidentally killed by a German doctor working his first out-of-hours shift in Britain. Dr Daniel Ubani was employed by TCN and working for a Cambridgeshire health trust at the time.

The interim report criticised TCN for failing to fill doctors' shifts and its policies for dispensing medicine.

Fears were also raised that PCTs such as NHS Suffolk were only “scratching the surface” in monitoring out-of-hours performance and risk failing to spot potential problems or poor care.

In the wake of that, TCN said it would continue to work with the CQC as investigations continued.

Jon Reynolds, head of contract management at NHS Suffolk, said yesterday: “In Suffolk, 86% of out-of-hours GP services are still covered by Suffolk GPs or GPs from towns in neighbouring counties.

“We would reassure people in Suffolk that delivering safe and effective clinical services is our priority. All the services we commission meet high standards of quality and safety and people should have confidence in them. Should any incident of below-standard service arise, we take it seriously, examine what has happened and take the appropriate action to address it.”

Geoff Reason, chief executive of Suffolk's Local Medical Committee, which represents GPs, said: “The service must be up to standard as part of the continuing care to patients.”