Staffing of Hackney’s privately-run out-of-hours care service is under review, and doctors have expressed “grave concern” about staffing levels.
Harmoni, the company contracted to provide out-of-hours (OOH) medical care in north London, has admitted there was no reception or doctor cover at the Homerton Hospital from 8pm on Easter Sunday, March 31, despite being contracted to provide a service.
GPs in Hackney are concerned that lack of doctor cover may have had an impact on patient care on other occasions, and the Gazette has seen dozens of emails sent out by Harmoni asking doctors to cover shifts at the last minute, some offering bonuses.
Coral Jones, the Hon Sec of the City and Hackney Division of the British Medical Association (BMA), said: “GPs have been informed that rotas are not always covered, including most seriously at night when on occasion there have been no doctors present, leaving a nurse to handle the calls.”
Under the Freedom of Information (FOI) Act the division asked to see Harmoni’s rotas for the past year but it refused to supply the statistics, saying it was exempt from such requests as a private company.
However doctors argue as a primary care provider, the information should be covered by the Act.
NHS North East London and the City (NELC) also asked Harmoni for the information, but again they refused citing commercial sensitivity.
Dr Jones turned to the Care Quality Commission (CQC) and was told by Ian Smart, compliance inspector for London, that Harmoni had recently undergone an inspection, which found evidence of staffing issues likely to impact on cover and service provision.
Harmoni – which has held the OOH contract under an interim arrangement since 2010 without a formal tendering process – is now reviewing a draft report from the QCC before a final report is published.
Dr Jones said: “If Harmoni are able to provide evidence of adequate cover then we will be very relieved, but the refusal to supply copies of the rota has served to further our concerns that Harmoni are hiding the details of inadequate rota cover.
“What matters is what they say they are doing and then if they don’t provide that.
“If you decide the service needs three doctors, if you cut it down, there’s a likelihood there’s potentially going to be a problem.”
A spokesman for Harmoni admitted that recruiting GPs to out-of-hours services is a challenge across the country for nearly all out-of-hours providers. “On rare occasions, a GP is, at the very last moment, unable to attend a shift to which he or she had committed, as happened at Homerton on Easter Sunday,” he said.
“Patients needing to see a GP during that time were instead offered an appointment with a GP at our Haringey base, less than two miles away.”
Doctors in Hackney spent two years drawing up plans to run OOH care under the guise of the City and Hackney Urgent Healthcare Social Enterprise, but NHS NELC allowed Harmoni to continue running the contract at the last minute in February while they put the contract out to tender.
A spokesman for the NELC said at the time that its priority was to ensure local people receive services that are “safe and of the highest quality”.
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