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Privatised GP service understaffed and missing targets, watchdog finds Privatised GP service understaffed and missing targets, watchdog finds
(35 minutes later)
A privatised out-of-hours GP service in north and central London does not have enough qualified, skilled or experienced staff to ensure it can meet patients' health needs, a watchdog has found.A privatised out-of-hours GP service in north and central London does not have enough qualified, skilled or experienced staff to ensure it can meet patients' health needs, a watchdog has found.
The verdict on Harmoni's operations in part of the capital comes months after a coroner ruled that no individual or systemic failing by the company was to blame for the death of a seven-week-old boy.The verdict on Harmoni's operations in part of the capital comes months after a coroner ruled that no individual or systemic failing by the company was to blame for the death of a seven-week-old boy.
The Care Quality Commission found the shortcomings during an inspection of care and treatment records in March, following a Guardian investigation into understaffing of the service. It found that Harmoni fell short on targets for triaging both urgent and non-urgent calls, and for making urgent home visits within two hours and routine ones within six hours.The Care Quality Commission found the shortcomings during an inspection of care and treatment records in March, following a Guardian investigation into understaffing of the service. It found that Harmoni fell short on targets for triaging both urgent and non-urgent calls, and for making urgent home visits within two hours and routine ones within six hours.
The CQC found that 52 shifts had been cancelled at short notice between October last year and the end of December, with one doctor cancelling on seven occasions.The CQC found that 52 shifts had been cancelled at short notice between October last year and the end of December, with one doctor cancelling on seven occasions.
Harmoni, the largest private provider of out-of-hours GP care in England, has contracts with 110 GPs and uses agency staff to provide services in north and central London.Harmoni, the largest private provider of out-of-hours GP care in England, has contracts with 110 GPs and uses agency staff to provide services in north and central London.
The company told the CQC that difficulties in recruiting enough GPs played a part in the failure to meet the required standards, as did underestimates of cover needed for the bank holiday period. It said it may need "a more attractive employment package". Harmoni told the CQC that difficulties in recruiting enough GPs played a part in the failure to meet the required standards, as did underestimates of cover needed for the bank holiday period. It said it may need "a more attractive employment package".
The CQC said 22% of patients who responded to a survey in December said the service was poor or unsatisfactory, and in a survey in January the figure was 17%. Until the staffing issue was resolved, "there is a risk that delays could affect the care and treatment by patients using the service", its report said.The CQC said 22% of patients who responded to a survey in December said the service was poor or unsatisfactory, and in a survey in January the figure was 17%. Until the staffing issue was resolved, "there is a risk that delays could affect the care and treatment by patients using the service", its report said.
Lawyers for the parents of Axel Peanberg King, who died last November after a cold developed into pneumonia, believe the criticism supports their contention that the service was not staffed properly and therefore could not provide the care it should have done.Lawyers for the parents of Axel Peanberg King, who died last November after a cold developed into pneumonia, believe the criticism supports their contention that the service was not staffed properly and therefore could not provide the care it should have done.
In February Shirley Radcliffe, the coroner who investigated Axel's death, delivered a narrative verdict, which did not apportion blame. She concluded that Harmoni's overall systems were safe and rigorous, although she concluded that the performance of the last doctor who had been in contact with the family had been inadequate. In February, Shirley Radcliffe, the coroner who investigated Axel's death, delivered a narrative verdict, which did not apportion blame. She concluded that Harmoni's overall systems were safe and rigorous, although she concluded that the performance of the last doctor who had been in contact with the family had been inadequate.
That doctor had taken one minute to investigating Axel's condition in a phone call and made "wholly inadequate" notes of the consultation in between seeing patients, booked at a rate of five an hour, at a Harmoni clinic where he was on duty, the inquest heard. By downgrading Axel's case from urgent to routine, there was a delay in him seeing a doctor the day he died. That doctor had taken one minute to investigate Axel's condition in a phone call and made "wholly inadequate" notes of the consultation in between seeing patients, booked at a rate of five an hour, at a Harmoni clinic where he was on duty, the inquest heard. By downgrading Axel's case from urgent to routine, there was a delay in him seeing a doctor the day he died.
Ellen Parry, the lawyer at Leigh Day representing Axel's parents, said: "This report supports our belief that the out-of-hours service run by Harmoni was not staffed properly and therefore did not provide the service it should have to our client and her baby boy, Axel.Ellen Parry, the lawyer at Leigh Day representing Axel's parents, said: "This report supports our belief that the out-of-hours service run by Harmoni was not staffed properly and therefore did not provide the service it should have to our client and her baby boy, Axel.
"Harmoni must realise that the safety of the service is directly linked to both adequate and appropriate recruitment and the service cannot be considered safe until they have solved this issue. If they cannot ensure adequate staffing, by good doctors, then I believe that the service is not fit for purpose and should be taken out of private, profit-based ownership.""Harmoni must realise that the safety of the service is directly linked to both adequate and appropriate recruitment and the service cannot be considered safe until they have solved this issue. If they cannot ensure adequate staffing, by good doctors, then I believe that the service is not fit for purpose and should be taken out of private, profit-based ownership."