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‘Short-staffed and substandard’ out of hours service

‘Short-staffed and substandard’ out of hours service


The contract of a “short-staffed and substandard” out-of-hours provider should have been terminated, leading the government to question CCGs contracting skills.

In Cornwall, the quality of private contractor Serco’s service “fell short of national quality standards” and the company falsified data on 252 occasions to improve the appearance of performance.

Whistleblowers had raised concerns about the £32 million service in early 2012, but the Public Accounts Committee (PAC) claim that the primary care trust (PCT) and the strategic health authority (SHA) did not demonstrate they had appropriate skills to negotiate with the provider. 

The PCT did not effectively scrutinise Serco’s performance, withhold payment or terminate the contract. 

Margaret Hodge MP, PAC chair said: “The failures in this contract matter, because the NHS will be making increasing use of private and voluntary providers to deliver NHS services. 

“We must have confidence in the ability of NHS commissioners to contract effectively, to monitor rigorously, and to extract appropriate penalties and where necessary terminate contracts. None of these conditions were met in Cornwall.”

Dr Laurence Buckman, chair of the BMA’s GP committee, agreed that the PAC report raises “serious issues”. 

He said: “It is clear in the case of Cornwall there was a complete breakdown in the regulatory framework that was supposed to ensure that patient care would not be comprised when NHS services were taken over by a non-NHS provider.  

“If we do not get a grip on the problems exposed today then we run the risk of seeing the failures in Cornwall becoming routine across the NHS.”


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