A TOP-LEVEL report claims NHS Trusts have been failing to carry out thorough checks on GPs providing out-of-hours care.

The challenges posed by offering care at night and on weekends – such as seeing unfamiliar patients without access to their medical records – means doctors need to be properly assessed for their clinical skills and competence in English, it said.

The report’s authors found “limited evidence” of robust checks on clinical skills alongside “misunderstandings” over whose responsibility it was to ensure doctors had good written and spoken English.

The report, commissioned by the Department of Health, comes after Cambridgeshire North and East Coroner William Morris recorded a verdict of unlawful killing in the inquest into the death of David Gray.

He accused German doctor, Daniel Ubani, of gross negligence following the death in 2008, and said “weaknesses remain” in the out-of-hours system, including the use of overseas and locum doctors.

The report said there were “unacceptable” variations in the standards of care offered by Primary Care Trusts around England, who are responsible for out-of-hours GP services.

PCTs commission services from a range of organisations including private firms, GP co-operatives and in-house teams at the PCT. The report said: “We discovered that most providers did not make an assessment of the clinical skills or competence of their clinical staff.”

It added: “The majority appeared not to use a clinical scenario type approach to interviews.”