GPs providing out
of hours care in England will be subject to tighter controls and
more robust skills and knowledge testing, Health Minister Mike
O’Brien announced today.
These tough new measures form part of a package that together
with stronger national standards and tighter monitoring of
performance will improve GP out of hours services.
The measures follow a report ‘General Practice Out of Hours
Services’ published by the Department of Health today. The
Department has accepted all of the report’s 24 recommendations and
expects all Primary Care Trusts (PCTs) to act on them as a matter
of urgency. PCTs have already been issued with interim guidance to
assist them in complying with their obligations to ensure all
doctors admitted onto their list of approved out of hours GPs have
a satisfactory knowledge of English.
Today’s measures will go even further, introducing stronger
national minimum standards and producing a model contract for PCTs
to use when procuring out of hours services. We will consult on
the content and expect it to be in place by the end of the year.
The Department will also look to GPs for input on how local out
of hours services meet the needs of their local communities.
PCTs will also be expected to regularly review their performance
management arrangements for their out-of-hours GP services,
ensuring they are robust and fit for purpose. Strategic Health
Authorities should also oversee how PCTs manage the performance of
out of hours GP providers.
Health Minister Mike O’Brien said:
“I extend my condolences to the family of Mr Gray. Patient safety
must be a top priority of the NHS. Although out of hours services
are much better than before 2004, some PCTs are not meeting their
legal obligations and I am determined to tackle this.
“I am accepting all the recommendations made in today’s report
and setting out new measures that go even further. These will
tighten existing controls and ensure that out of hours providers
are employing competent clinicians, providing safe and effective care.
“I expect all PCTs to act on these recommendations as a matter of
urgency. It is unacceptable for any Trust to fail to meet its
obligations on safety and quality of care.
“By April 2012 every provider of GP healthcare, including out of
hours providers, will need to be registered with the Care Quality
Commission and will be subject to checks on compliance.”
RCGP Chairman, Professor Steve Field said:
“Regardless of where they live patients must feel confident that
they are receiving high quality care out of hours. There are
examples of excellent Out-of-Hours services around the country but
as recent events have shown, there are areas where care is not as
good as patients deserve.
“We’re pleased that Minister of State Mike O’Brien has accepted
our report in full and that the Government is taking the right
steps in ensuring that patients will receive consistently good
care across the country.”
The report, conducted by Dr David Colin-Thome, National Clinical
Director for Primary Care at the Department of Health, and
Professor Steve Field, Chairman of Council, Royal College of
General Practitioners was commissioned by Mike O’Brien in October
2009 and looked at current arrangements for out of hours services.
It found that there are already robust requirements in place to
ensure the commissioning and delivery of safe, high quality
out-of-hours services, but there is unacceptable variation in how
these are implemented and monitored by Primary Care Trusts around
the country.
Notes to Editors
The full report contains 24 recommendations in total. It can be
found at www.dh.gov.ukThe report outlines a number of
recommendations to improve the commissioning and provision of out
of hours care including that: Primary Care Trusts should review
the performance management arrangements in place for their
out-of-hours services and ensure they are robust and fit for
purpose;The Department of Health should issue guidance to Primary
Care Trusts to assist them in making decisions about whether or
not a doctor has the necessary knowledge of English; The
Department of Health should develop and introduce an improvement
programme for Primary Care Trusts to support their commissioning
and performance management of out-of-hours services;Out-of-hours
providers should consider the recruitment and selection processes
in place for clinical staff to ensure they are robust and that
they are following best practice in this area;Strategic Health
Authorities should consider how they monitor action taken by
Primary Care Trust in response to this report and in carrying out
appropriate performance management of out-of-hours providers; and
Providers should co-operate with other local and regional
providers (both in and out-of-hours) to share any concerns over
staff working excessive hours for their respective services. The
out of hours period generally refers to:
(a) the period beginning at 6.30pm on any day from Monday to
Thursday and ending at 8am on the following day,
(b) the period between 6.30pm on Friday and 8am on the following
Monday, and
(c) Good Friday, Christmas Day and bank holidays.
By the Beginning of 2004, approximately 70 per cent of GPs had
delegated the responsibility to a GP co-operative, and around 25
per cent to a commercial provider. By April 2005, 75 per cent of
out-of-hours provision was carried out by the Trusts themselves or
through co-operatives, with the remaining 25 per cent provided by
commercial providers, ambulance trusts and others, and with NHS
Direct supplying initial call handling for many providers. NHS
Chief Executive David Nicholson will be writing to PCTs to remind
them of their legal obligations and to urge them to implement the
recommendations in the report.For more information please contact
the Department of Health press office on 020 7210 5221.
Contacts:
Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk