OUT-OF-HOURS PROVIDERS FAILING KEY STANDARDS - LAMB

10.24.37am BST (GMT +0100) Wed 12th Sep 2007

Nearly a third of local health trusts are failing to meet official standards on out-of-hours care to identify life threatening conditions over the phone, according to research by the Liberal Democrats.

Freedom of Information requests submitted by Liberal Democrat Shadow Health Secretary & North Norfolk MP Norman Lamb show that out-of-hours care provided by Primary Care Trusts often fails to meet full health and standards of care requirements set by the Government.

The research comes in the week that Norman Lamb will publish his vision paper on the future of the NHS that will include a 'Patient's Contract' guaranteeing high standards of out-of-hours care.

The research shows:

· Nearly a third do not meet full standards in carrying out a telephone clinical assessment, used to identify immediate life threatening conditions.

· More than four out of every ten providers do not meet full standards in answering patient's initial calls quickly.

· Over a quarter of providers do not meet full standards in starting face-to-face consultations on time.

Commenting, Norman Lamb MP said:

"These very disturbing statistics show that many Primary Care Trusts are failing to meet standards of care which the Government itself says is crucial.

"Out-of-hours care looks at potentially life and death situations. Answering calls quickly and providing a swift and accurate phone diagnosis can save lives.

"It is critical that the public has confidence in the care that is provided to them when they can't see their GP. The danger is that people will choose to go to already crowded A&E units, which have seen a rise in admissions in recent years.

"The problem is that there is no way to hold providers to account for inadequate services; Primary Care Trusts are not answerable to anyone for their actions.

"A Patient's Contract guaranteeing high standards of out-of-hours care and a system of local democratic control over services would keep standards high."

NOTES & FURTHER READING

1. The Liberal Democrats sent out Freedom of Information requests to all Primary Care Trusts (152), receiving replies from 92 trusts asking which Department of Health 'Quality Requirements' they are complying with. The information shows:

• 42% of PCTs surveyed do not meet full standards in answering patients' initial calls quickly

• 32% do not meet full standards in carrying out a telephone clinical assessment that are used to identify immediate life threatening conditions over the phone.

• 27% do not meet full standards in starting face-to-face consultations on time.

• 23% do not meet full standards in sending details of all out-of-hours consultations (including appropriate clinical information) to the practice where the patient is registered by 8.00 a.m. the next working day.

• 15% fall short of full standards in face-to-face clinical assessment that are also used to identify immediate life threatening conditions.

2. Primary Care Trusts are asked to comply with 13 Quality Requirements.

See Appendix 5 of last year's National Audit Office report into the provision of out-of-hours care in England:

http://www.nao.org.uk/publications/nao_reports/05-06/05061041.pdf

In a number of areas, providers have to demonstrate 100% compliance, for example:

• Answering calls within set time limits

• Starting definitive clinical assessment within a set time from the start of call

• Starting definitive clinical assessment for urgent patients within a set time

• GP is available where a consultation is clinically appropriate

• Emergency face-to-face consultation within a set time limit

3. A report in May that looked into the circumstances surrounding the case of a woman in North London who had died after seeking out-of-hours treatment found that a failure to pass on information about her condition had contributed to her death.

http://news.bbc.co.uk/1/hi/health/6689483.stm

4. The new data uncovered by the Liberal Democrat show that a year on from a National Audit Office report on the standards provided by Primary Care Trusts on out-of-hours care, the situation has not significantly improved. Similar standards are falling short around the country. Yet the Government says:

Andy Burnham, 26th June 2007: I can confidently say that we have improved out-of-hours care. Indeed, the National Audit Office review of out-of-hours services found that those services are broadly on track and improving. Indeed, satisfaction levels for out-of-hours care show that eight out of 10 patients say that their care is satisfactory. Again, I remind the hon. Gentleman that the out-of-hours service was close to collapse in parts of the country. GPs were not joining the profession, because they were not prepared to take on a 24-hour commitment to providing out-of-hours services.

5. This Friday, Liberal Democrat Shadow Health Secretary, Norman Lamb MP is set to publish his Vision Paper on the future of the NHS. The paper will call for a Patient's Contract, which includes a guarantee of high standards of out-of-hours care.