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GP out of hours social enterprise costs more than Harmoni, but hopes to reduce A and E admissions

PUBLISHED: 19:30 10 October 2013 | UPDATED: 19:30 10 October 2013

Dr Nick Mann

Dr Nick Mann

Archant

Although the GPs' social enterprise out-of-hours service will cost more than the one Harmoni currently provides, the Clinical Commissioning Group (CCG) thinks the extra £1.6million cost will be offset by savings elsewhere.

Last week it was announced City and Hackney Urgent Healthcare Social Enterprise (CHUHSE), a not-for-profit social enterprise run by local GPs, had won the bid to deliver healthcare when doctors’ surgeries are closed, in a contract costing £6.4m over four years.

CHUHSE’s bid and that of an unknown bidder for the contract were given scores based on nine different criteria and the unknown bidder beat CHUHSE in the “financial and commercial requirements” section, proposing a cheaper service.

However, CHUHSE came out top in all other eight sections, including clinical governance and patient focus, bringing its overall per centage score to 74.44 compares to the other bidder’s 49.41 per cent.

The risks of awarding the contract to CHUHSE – a start-up business with potential cash flow risks – were discussed at an extraordinary CCG board meeting on September 17.

But a spokesman for the CCG said that the independent, expert evaluation panel which assessed the bids was impressed with CHUHSE’s detailed submission and clinical model. They hope it will be able to deliver a high quality service, which will hopefully create reductions elsewhere in the health economy.

At the CCG board meeting on Friday when the successful bidder was announced, GP Victoria Holt, who was instrumental in putting together the bid, was asked whether the extra £1.6m cost of the contract would be mitigated by reducing A&E referrals.

She said: “There will be an ethos in supporting a GP who goes on a visit and spends longer there setting up a first response and establishing safety, all of which takes time, but we are going to have more resources and can save a (hospital) admission.

“We are not just talking about zero lengths of stay, we can save weeks of admission and potentially, I think that is where the real savings are going to come about.”

The service will work in close collaboration with the Homerton Hospital, where the main base will be.

The plan is to have additional bases open at peak times on Saturdays and Sundays at the Lawson Practice, Nuttall Street, Hoxton and the John Scott Centre, Green Lanes, Finsbury Park, so that people don’t always have to trek all the way to the Homerton.

CHUHSE already has 34 local GPs signed up to work shifts.

“It looks like staffing is not going to be a huge problem. We put in a bid which means two doctors can be on and not just one. It’s a fully staffed rota and it will have more of a capacity to deliver a service,” Dr Holt told people at the meeting.

“The recruitment process has been amazing. GPs have in good faith applied to work for an organisation which didn’t have a contract and didn’t even exist. It’s really heartening,” she added.

“Ideas that went into the bid came from interviews, which I think makes us a more sustainable organisation because people’s views on how the service should function have been listened to.”

Harmoni was criticised by health inspectors from the Care Quality Commission in June, when their report concluded “there were not enough qualified, skilled and experienced staff to meet people’s needs” at Harmoni North East London, which covers Islington, Hackney, Camden and Haringey.

The CQC raised concerns that Harmoni was “potentially putting patients’ safety at risk”, and that at times GPs have not been available at clinics to see patients. On Easter Sunday for example anyone who wanted to see a doctor would have been sent to a clinic in Haringey instead of the Homerton.

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