Out-of-hours GP service ‘clinically unsafe’, report warns

A report into Integrated Care 24 (IC24) has found that out-of-hours GP calls faced waiting times of more than 12 hours and labeled the services as ‘clinically unsafe’ and a ‘significant risk to patient safety’.

IC24 runs non-emergency 111 and out-of-hours services in areas such as Great Yarmouth and Waveney, parts of Essex and Norfolk and Wisbech. The report outlined a number of deficiencies regarding call handling and GP shortages.

Assessors from the Norwich Clinical Commissioning Group (NCGG) inspected five IC24 bases in Norfolk and one in Cambridgeshire during the month of November 2015, after complaints were submitted by staff.

The report highlighted issues such as: an ‘emerging trend’ of 111 callers waiting to be processed and an IT system that did not allow patients to be triaged effectively; the call-handling system was ‘unclear for patients’ with some ‘waiting in excess of 12 hours from their first contact which is clinically unsafe posing a significant risk to patient safety’; staff ‘asked to alter or not record accurately their contemporaneous notes’; staff said they had been unable to comply with requests, including ‘removing unseen patients from their screens in the morning and advised that a non-clinical member of staff had cleared the screen’ of callers not dealt with; ‘an element of fear’ among staff over reporting concerns; a lack of GPs, having a ‘direct impact on the quality and clinical safety of the service’ and on doctors themselves; staff concerns over ‘competency skills of individuals recruited to fill the GP shortfall’; and GPs unhappy at being consistently moved between bases to cover shortfalls.

IC24 has apologised for its short failings but maintained that it had followed procedures.

Karen Watts, author of the interim report into IC24, concluded it was ‘not clinically assured of the safety of the out-of-hours service’ and only ‘partially assured’ of the 111 service. She also claimed the CCG believed the issues had a ‘negative impact on recruitment and retention of the existing workforce’.

Yvonne Taylor, IC24 chief executive, said: "As an open organisation, I would like to reassure our patients that we continue to work with our commissioners to provide a robust and transparent service for our patients."

Watts has advised that IC24 provide a detailed improvement action plan by the start of December.