GPs consider taking out-of-hours care back of UC24

Mar 17 2008

AROUND a third of doctors are interested in the idea of taking back control of their out-of- hours service for more pay, a programme will claim tonight.

It follows concerns over the quality of the 24-hour service provided by some primary care trusts, including Urgent Care 24 (UC24), the out-of-hours GP service for 1m patients on Merseyside.

In 2004, a majority of GPs accepted an offer to opt out of providing round-the-clock care for their patients in return for a £6,000 average drop in salary, with responsibility handed to primary care trusts.

But a survey conducted for ITV1’s Tonight suggests that some doctors are unhappy with the current service and are willing to shoulder the responsibility again if funded to the same level as the current provider.

It is claimed that the costs associated with out-of-hours services – usually contracted out to a private company or consortium of GPs – is higher than the equivalent of £6,000 per doctor.

A poll carried out by doctors.net.uk on behalf of Tonight’s Doctor Who? programme, to be aired at 8pm, found that 10% of doctors said they would “definitely be willing” to retake control and 22% said it would be a possibility. Just under half of the 1,537 respondents said they would not consider taking on round-the-clock care, with 18% stating “probably not”.

Vanessa Bourne, head of special projects for The Patients Association, said: “I think that figure of one in three is actually very interesting.

“It suggests they are unhappy with their out-of- hours provider and it means that they are not happy GPs and an unhappy GP doesn’t do the best for his patients.”

She added: “It’s changed the relationship that a patient has with their GP above all, so that they no longer feel that they have that 24-hour guardian and gatekeeper into the NHS, which is what the ideal is.”

Dr Srinivas Dharmana, who recently agreed a settlement with UC24 over an unfair dismissal claim, told interviewers he was so worried about the service he told patients to phone his personal mobile number if they had an urgent query.

He claimed that next to no case history is passed on to him after his patients are seen by the out-of-hours doctor.

Dr Dharmana said: “For example, this particular lady has given them a call to say she is thinking of suicide.

“We don’t have any information of first of all what the doctor’s done. It just says outcome: No diagnosis, no complications...What I need to know is whether this patient actually attempted the suicide or is seeing some sort of psychiatric unit.”

Responding to his complaint, Dr Chris Mimnagh, medical director for Knowsley Primary Care Trust, a UC24 user, said: “If he has concerns he should take them to the PCT. I don’t know how happy you’d feel knowing that your doctor had been up the night before seeing patients, perhaps a bit tired, on call 24 -hours a day, it doesn’t sound like safety does it.”

The Daily Post has revealed several cases of alleged misdiagnosis by UC24 during consultations, the most recent being Debbie Judic’s 16-month- old son, Sonny, who was rushed into hospital with pneumonia after being told by two GPs he only had a head cold.

In other cases, Christie Millar, 21, from Ellesmere Port, spent six weeks in a coma having been rushed into hospital with a ruptured appendix in May 2006. A locum doctor at UC24's walk-in medical centre in Old Swan gave her an anti-sickness injection and sent her home. Soon after, she was fighting for her life in hospital.

The parents of 28-year-old Julie Barr, from Netherton, who died from a heart attack, believe their daughter would still be alive today if her symptoms had been recognised sooner by UC24 staff.

But the Wavertree-based organisation said last year it was now meeting 11 out of 13 of the National Quality Requirements (NQR) set out by the Department of Health for out-of-hours GP care.

And a recent independent survey put UC24 above average in 28 out of the 30 ratings used in an independent survey with overall “satisfaction with help” scores for UC24 were a full 10% above the national average for assistance provided at their urgent care centres, and 7% above the national average for home visits by GPs.