Health inspectors find private company Harmoni is jeopardising Hackney patients’ safety through lack of doctors

Homerton University Hospital, in Homerton Row where Harmoni failed to provide out of hours doctor co

Homerton University Hospital, in Homerton Row where Harmoni failed to provide out of hours doctor cover on Easter Sunday. - Credit: Archant

Care Quality Commission inspectors have found private company Harmoni guilty of running the out-of-hours (OOH) GP service for Hackney with so few doctors they are potentially placing patient’s safety at risk.

Last week the Gazette reported that the Care Quality Commission (CQC) was reviewing staffing levels at Harmoni North Central London.

The company admitted there had been no doctors based at Homerton Hospital on the evening of Easter Sunday, despite being contracted to provide a service when GP practices are closed.

Now the CQC report has been published and concluded “there were not enough qualified, skilled and experienced staff to meet people’s needs” at Harmoni’s service, which covers Islington, Hackney, Camden and Haringey.


“On occasions staff have not been available at clinics to see patients,” said the report.

“This has resulted in falls in patient satisfaction and potentially places patients at risk of not having the care and treatment they need.”

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In fact, figures covering November 2012 to January 2013 show Harmoni failed to comply with the National Quality Requirements (NQR’s) targets of 95 per cent in four separate areas.

Between 14 to 16 per cent of urgent calls were not dealt with within the 20 minute target, and 17 to 38 per cent of non-urgent calls were not triaged within an hour.

Meanwhile, between 12 to 17 per cent of urgent home visits took place out of the two-hour target time, and between 14 to 18 per cent of routine home visits took longer than six hours.

Dr Deborah Colvin said GPs had told the NHS Primary Care Trust about these problems two years ago and found it “depressing” their warnings had not been heeded.

“Of course they are putting people at risk, if you are running an out-of-hours service for thousands of people and you don’t have enough doctors that’s dangerous,” she said.

“One of my real concerns is that for out of hours to be done properly costs money.

“If you set up a procurement so the most important thing is the cost, and you score points by offering the cheapest service, you can see sooner or later it becomes so cheap it can’t do what it says on the tin.”


The CQC makes checks in five different categories, including staffing, and it found all other standards were being met by the company.

Harmoni – which has held the OOH contract under an interim arrangement since 2010 without a formal tendering process – must now come up with an action plan in response to the findings.

A spokesman for Harmoni admitted that recruiting GPs to out-of-hours services is a challenge across the country for nearly all OOH providers.

“Harmoni has a robust recruitment process in place which addresses future recruitment, but also the more immediate needs of filling rotas,” he said.

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.

Harmoni has come under fire in the last few months from health campaigners, with scrutiny intensifying after the death of seven-week-old baby Axel Peanberg King in November after he stopped breathing at Harmoni’s clinic in the Whittington Hospital.

A coroner subsequently raised concerns over his treatment.

Three years ago, Dr Fred Kavalier resigned from his position as lead clinician of Harmoni, stating his “concern about the quality and safety of the service” in north central London.

Harmoni North Central London is managed from an administrative base at St Pancras Hospital, and face-to-face consultations are also available at the Whittington Hospital in Islington, The Laurels Medical Practice in Haringey and the Homerton Hospital in Hackney.