Out of hours doctors must be fit to practice and speak English
Out of hours GPs providing care to patients in England will now be facing more rigorous skills testing in a bid to improve the quality of care they provide.
The move comes in the wake of a new report and an inquest into the death of a patient being cared for through the NHS out of hours service.
On an out of hours call out, Dr Daniel Ubani gave patient David Gray, up to 20 times the recommended amount of diamorphine to treat kidney pain, resulting in his death.
Having only arrived in England from Germany to work the day before, the doctor was not only tired, but had no experience of working in the NHS and subsequently failed an English test.
A ten day inquest into Mr Gray’s death found serious problems with GP out of hours care in the NHS.
During the inquest, the coroner for Cambridgeshire North and East, William Morris, called on Health Secretary Andy Burnham to introduce measures designed to make sure that this situation never happened again.
A new report released yesterday by the Department of Health, the ‘General practice Out of Hours Services’ accepted a finding that there is an unacceptable variation in how Primary Care Trusts (PCTs) deliver safe out of hours services.
Now, new measures will ensure that PCT will have to work to a national minimum standard.
The approved doctors on their out of hours lists must also have a satisfactory standard of English and they must be regularly monitored to make sure they are fit for their work.
Health Minister Mike O’Brien said that by April 2012, GP healthcare providers, including those providing out of hours doctors will need to register with the Care Quality Commission and be subject to checks.
He 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.
The report was conducted by the National Clinical Director for Primary Care at the Department of Health’s Dr David Colin-Thome and the Royal College of General Practitioners Chairman’s Steve Field.
Professor 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
Responding to the report Chairman of the British Medical Association’s GPs Committee, Dr Laurence Buckman said: “The BMA agrees with this report when it says out-of-hours provision is unacceptably patchy. There are some out-of-hours organisations that provide a quality service and others, as has been highlighted by the tragic and avoidable death of David Gray, that fall shockingly short. We think the recommendations made in this report are sensible and are glad to see the government has accepted them in full. We welcome the proposal for greater involvement of local GPs in assessing the quality of services. We hope this, combined with proposals to improve monitoring of services and the selection of clinicians, will raise the standard of out-of-hours across the board so that all patients, no matter where they live, receive high quality care.”