Patients at risk due to lack of after hours GP services

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Patients do not know where to turn when their GP practices have closed for business.

A report issued by the Public Accounts Committee, states that fragmented and complex systems leave patients confused about where they can turn for help, with far too many of them ending up at A&E departments.

Health officials have been accused of failing to offer basic information explaining the unacceptable differences in the standards of care offered by out-of-hours services.

The report has accused NHS England of ‘inadequate’ oversight as to whether services are offering value for money. The costs of these services range from £29 to £134 per case.

The committee chairman, Margaret Hodge, said patients are unaware of the different options available to them, such as walk-in centres, urgent care centres and out-of-hours GP services, and they have no idea how to contact them.

The report found that about one third of adults in the UK have not heard of NHS111, which is the non-emergency telephone line, or they are unaware of what it is to be used for. Around 25% were unaware that there were out-of-hours GP services, particularly young people and those from minority ethnic and black communities.

The report has issued warnings that there may be possible conflicts of interests between the services that offer cover and GPs due to mismanagement. In many instances GPs hold financial interests in the organisations which offer cover.

The fears regarding these conflicts has increased since the controversial NHS reforms by the Government handed power to purchase healthcare to clinical commissioning groups (CCGs).

According to Margaret Hodge, some CCGs awarded contracts without a suitable procurement process and this has increased the risk to value for money and propriety. She stated that CCGs should show how they manage conflicts of interest and NHS England should ensure that their guidance is being adhered to.

She placed focus on the case of the Barnet, Enfield and Haringey CCGs in North London, where it was found that eight of the Barnet group members hold shares in Barndoc Limited, which offers out-of hours services, and one member is the chairperson. It was found that five CCGs members in Enfield and Haringey also hold shares in the company.

MPs have urged the Government to ensure that there will be an adequate number of GPs to cope with the increasing workload.

NHS England stated that there should be clarity between the people who make commissioning decisions and those who benefit from those decisions. It has issued adequate guidance to CCGs on the management of conflicts of interest, including when there is conflict with a group of members.

NHS England is set to undertake assessment of the compliance of GPs with the requirement that those involved in bidding have no involvement with the procurement process.

Image Credit: Waldo Jaquith

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