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Out of Hours GPs Safety Report

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9:36am 21st September 2012
(Updated 9:36am 21st September 2012)

Pirate FM has learnt data on patient response times at Cornwall's out-of-hours doctors was changed more than 250 times in six months.

The entries made by staff at HQ have come to light after Serco ordered its own investigation.

Bosses are apologising, saying they do not know why data was manipulated and they are working to get to the bottom of the problem.

But St Ives' MP Andrew George wants an independent panel to monitor the service: "If there's manipulation of data which is actually perhaps hiding what is really going on then it's unlikely we're ever going to get an improvement in the service. We need to have faith in the commissioners as well as the suppliers of the service."

It comes after an independent report, commissioned after an investigation by the watchdog, warned it cannot guarantee the service will stay safe unless more doctors are recruited.

At the outset I did not find any evidence that the current out-of-hours service is or has been systematically clinically unsafe.

As with most health care organisations there have been cases of poor care but no systematic unsafe care. But until all significant problems and in particular of GP staffing are rectified, I cannot say with certainty that the service will remain safe.

Full clinical staffing on a regular basis of the clinics, the home visiting car service and the call centre couple with a more comprehensive application of clinical governance would be sufficient for a safe service.

Read the full report.

Paul Forden is in charge of clinical services at Serco and has said: "We recognise that without adequate levels of staff it won't be a safe service and safety is paramount. It doesn't matter to me how much I spend on this contract, it will be safe first.

"We've increased the pay of the GPs, we've actually recruited new GPs from outside, we've also increased the other staff because, for example, if you haven't got enough drivers, then it's still not a safe service so we're making we've actually got enough other staff to support the service as well."

The report was commissioned following an investigation by the Care Quality Commission into claims surrounding staff training, the way the quality of care is monitored, staff working double shifts and data entries being manipulated.

It also calls for a much sharper and evaluative approach to clinical governance, adding that, the Primary Care Trust is ranked highly in the PCF benchmark for regular and thorough review and monitoring of out-of-hours care. But they and their commissioning successor in 2013 will in my opinion need to extend the scope of that process as recommended in this review.

Statement from Cornwall and Isles of Scilly Primary Care Trust:

Dr Colin-Thomè has made a number of recommendations which will be considered by the PCT Board at its public meeting on Tuesday 25th September.

The Board will also receive an update on the further work undertaken by Serco looking at its data recording processes. This work has shown that in a small number of cases computer records were changed and there was insufficient justification for those changes. The PCT has been told they were unauthorised and involved 0.2% of records between January and June 2012. Serco has apologised and will work with the PCT to strengthen its data handling procedures and controls to ensure consistent reporting in future.

In reviewing the impact, the PCT is clear that the changes were minimal and short-lived.

The PCT will now carry out independent validation of Serco's report which will be repeated in six months.

Steve Moore, chief executive of NHS Cornwall and Isles of Scilly which commissions the service, said: "I was disappointed to learn that some of the data we received to measure performance was inaccurate although the number of inaccurate records was small.

"I am clear that Serco did not gain from these actions and they have issued a full apology to us.

"I am pleased to say that patient satisfaction with the service remains high and Serco is working constructively with us to address the issues raised by our review. We are confident that their aim is the same as ours, to provide a consistently high quality service to the people of Cornwall."

9:36am 21st September 2012

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