Out-of-hours service 'failures'

http://news.bbc.co.uk/go/rss/-/1/hi/health/6897727.stm

Version 0 of 1.

By Simon Cox Five Live Report Managers say problems have been resolvedA catalogue of failures in patient care has been revealed by a former head of an out-of-hours service.

The problems occurred in the Merseyside area after responsibility for handling calls passed to Urgent Care 24 (UC24) last October.

They included a doctor being sent to a dead person's house and a patient being sent to a supermarket to look for a walk-in centre that didn't exist.

UC24 admits there were problems when they first took over call handling, but says they have now been cleared up.

In May, the Commons Public Accounts Committee issued a stinging report into the nationwide introduction of new out-of-hours providers.

It said the system had cost 20% more than it was supposed to. The changes followed the decision to allow GPs to opt out of providing out-of-hours care.

Priority calls

In order to save money, responsibility for handling patients' calls for parts of Merseyside was transferred from NHS Direct to UC24, a not for profit out-of-hours service covering parts of Merseyside.

There were other things that could have been done that would have been safer for patients Dr Peter Entwistle

Serious problems emerged soon after the new service took over, says Dr Peter Entwistle.

He was working at the time as medical director of the Southport and Formby out-of-hours service (SPOOC), which was dependent on UC24, for handling calls and passing on patient details.

"The first thing that we noticed was that most of the calls were being over-prioritised," he said.

"The vast majority were being prioritised as urgent or emergencies."

The BBC Five Live report has seen documents showing how call handlers prioritised 60% of calls in the first two weeks of December as needing urgent treatment.

According to Dr Entwistle, the vast majority were routine cases, and only 10% were urgent cases.

He believes this could have serious implications: "The danger with that is that the genuine emergencies, it would be easy to miss them."

Lost patients

This was not the only change he noticed, when UC24 started handling calls. Patients began getting lost in the system.

We made sure that the systems were put into place to resolve those problems and we are now performing at a very high level Dr Simon AbramsMedical director, UC24

The case of an elderly patient who had to wait over five hours to see a doctor stood out.

"That patient was in pain all day and he required emergency surgery," said Dr Entwistle.

"The call was delayed for about five or six hours. That call was obviously an urgent call and should have been dealt with in the hour."

The Five Live Report has also seen emails between SPOOC and UC24 listing a series of failures over Christmas 2006.

These include a doctor being on a home visit to a patient who had died the previous year and doctors getting police to break into a house which turned out to be the wrong address.

Resignation

Dr Entwistle was so perturbed by the difficulties that he resigned from SPOOC at the end of last year.

John Pugh MP has serious concerns

He said: "I appreciate we all have to live within financial constraints. I think at this point there were other things that could have been done that would have been safer for patients."

Dr Entwistle's concerns relate to the period after UC24 took over the contract for call handling in October 2006 up until January 2007.

Dr Simon Abrams, the medical director of UC24, admits there were problems when the company first took over call handling but says they have now been cleared up.

He said: "We made sure that the systems were put into place to resolve those problems and we are now performing at a very high level.

"We had a careful primary care trust review because of some of the concerns that you raised and we're very pleased that review showed that we'd dealt with our issues, and the Primary Care Trusts recognised that we'd improved substantially and actually extended our contract."