A ROW which has been brewing for some time in relation to out-of-hours (OOH) cover by doctors is set to continue to bubble. Recent press reports of out-of-hours cover overnight being as low as one doctor for 650,000 people have caused a stir.
Last month the government acknowledged that OOH was unacceptable in terms of the variation of cover throughout the country.
But many GPs had long been of the view that the service was generally inadequate. The government's soul-searching was initia
lly limited to bemoaning the differences in cover between some areas, rather than acknowledging that OOH was generally not fit for purpose.
This followed an investigation by a national newspaper which it had contacted 152 PCTs. The investigation disclosed wide disparities in UK coverage: Barnet and Enfield in North London had the headline-grabbing one doctor for 650,000 people. If replicated this would mean that less than 100 doctors would be available for the whole of the UK. Sheffield had fared slightly better with two doctors for 530,000 people.
Various factors have contributed to the latest flurry of headlines:
The Care Quality Commission's announcement in June last year that it would investigate Take Care Now which provided OOH services to five PCTs. A foreign doctor they retained had given a lethal injection to a patient in February 2008.
The CQC's initial observations that a problem may exist throughout the NHS.
Reports late last year that Suffolk PCT, who had used Take Care Now, had OOH cover of just threeand sometimes only two GPs for a population of 600,000. Suffolk subsequently decided not to renew Take Care Now's contract.
Retention of the Primary Care Foundation by the Department of Health to develop benchmarking for the service – a tacit acknowledgement by the government of systemic failings in the OOH service.
The final report of the Care Quality Commission is at the drafting stage; there is potentially serious political fallout..But the general election may conveniently delay publication.
The Conservatives have pledged to reform OOH through renegotiating the contract GPs have. This leaves cash-strapped PCTs with nowhere to go in terms of a quick solution to this issue, but a financial reason not to do anything too hasty.
Watson Esam provide professional, employment and property legal advice to GPs and their practices during normal hours and sometimes even 'out of hours'.
For further information contact Guy Lachlan on 0114 275 3350 or
guy.lachlan@watson-esam.co.uk.
www.watson-esam.co.uk