Out-of-hours GP services told to improve or close

Catalogue of failings in staff levels and training

Out-of-hours GP services in east Kent have been plunged into special measures after being rated inadequate by inspectors.

The damning report from the Care Quality Commission (CQC) highlighted a catalogue of failures including staff being unclear about their roles, medicine not being recorded properly, and a lack of staff to treat patients.

Primary care provider Primecare has been told it has to improve its performance in providing on-call GP services at weekends and overnight when surgeries are closed, or it will have its contract be ripped up.

The company is the provider of the out-of-hours service for 700,000 patients in Ashford, Shepway, Dover, Deal, Canterbury and Thanet.

Inspectors noted there were “frequent medicine discrepan- cies” between doctors’ bags, which were put down to “poor medicines recording”.

This led bosses to centralise where controlled drugs were held at one location in east Kent.

But the CQC said it meant medicines were not “readily available when needed”, leaving staff to have to travel across the county to source and prescribe drugs.

The report adds: “Emergency medicines were not always easily accessible. The only oxygen available at one primary care centre was in the vehicle so was unavailable if it was on a call.

“We were told this centre was dependent on oxygen from the hospital’s A&E next door. We found some staff who did not know where emergency medicines were located.”

Some staff involved in handling medicines had not received “training appropriate to their role”, the report says.

Recruitment of staff was also shown to be an issue, with inspectors noting “the skill mix was unable to meet the needs of patients”, and that “too many nurses, paramedical staff and emergency care practitioners” were employed.

Many of these staff were restricted about which patients they could see.

The report acknowledges that Primecare has “increased the number of GPs employed and decreased numbers of other staff”.

It added: “Staff said patients were sent to centres where staff on duty could not treat them. Patients then had to be referred to another centre where suitable qualified staff were available.”

But it was reported that staff treated patients with “compassion, dignity and respect”.

‘Staff said patients were sent to centres where staff on duty could not treat them’