Inquiry into out-of-hours medical care

A FORMAL investigation is being carried out into out- of-hours medical care in Suffolk following concerns about patient safety.

Ipswich-based private healthcare company Take Care Now (TCN) is under the spotlight over a series of failings in patient care - including two cases of patients being given too much of potentially fatal drug diamorphine in Suffolk, and another which left a Cambridgeshire man dead.

National watchdog, the Care Quality Commission (CQC), has pledged to thoroughly investigate all concerns about the company, which also runs out of hours dentistry, minor injuries units, and - controversially - sexual health services, in Suffolk.

It will also examine if commissioner NHS Suffolk was stringent enough in checking patient safety standards.

The news was welcomed by a concerned Suffolk patient yesterday, who has complained about the care given to her mother by TCN.

The company, which does not hold public board meetings, was plunged into the spotlight following the death of David Gray, a Cambridgeshire patient who was treated by a locum doctor from Germany and given a lethal dose of diamorphine.

After the tragedy former health minister Ben Bradshaw said in the House of Commons that other incidents involving TCN were being investigated - referring to two Suffolk cases of concerns about doctors giving the same drug to patients in the county.

Diamorphine is a strong painkiller, which can be fatal in high doses and was used by Dr Harold Shipman to murder his patients.

NHS Suffolk said both incidents in the county had been thoroughly looked into in 2007 and as a result changes had been made to procedures.

Yesterday the CQC said it will look at TCN's service generally, conduct a retrospective review of events, and examine management of calls, staffing arrangements, pharmacy arrangements and the supply of medicines, and governance and quality checks in place for monitoring the contract.

Christine Braithwaite, head of investigations and enforcement at the CQC, said: “We have clear reasons to review where patients have suffered harm, and will rigorously identify where things went wrong.

“If we find areas of concern that require immediate attention, we will not hesitate to use our powers to make sure the safety of patients is not compromised.”

David Cocks, chief executive of TCN, said: “We recognise that it is the correct body to review the systems relating to the provision of out-of-hours GP support and to make informed recommendations, if appropriate, to the benefit of patients and healthcare providers.”

A spokesman for NHS Suffolk said: A spokesman for NHS Suffolk said: “The safety of our patients is our number one priority. We will cooperate fully with the CQC's investigations and carefully consider any recommendations made as a result of the review."

People interested in talking to the CQC can e-mail mark.tempest@cqc.org.uk or telephone 0207 4489207 if they think that they might have relevant information to contribute.

Take Care Now and out of hours care

Take Care Now (TCN) was set up in 1994 as Suffolk Doctors on Call to provide out of hours care to patients in Suffolk

The term out-of-hours care refers to care delivered between 6.30pm and 8am on weekdays and at all times during weekends and public holidays

Before April 2004 GPs were responsible for this care, but most provided the service either by pooling their responsibility through a GP co-operative (such as Suffolk Doctors on Call) or delegating it to a commercial deputising service

From April 2004 the Department of Health gave GPs the chance to opt out of responsibility for the service and the local primary care trust took over responsibility

In Suffolk only Bildeston GP practice still provides out of hours care to its patients

Since 2004 TCN has expanded outside Suffolk and now provides out of hours care in Suffolk, Cambridgeshire, Essex, Worcestershire and Great Yarmouth and Waveney

It has also branched out into other aspects of healthcare and runs Ipswich's minor injuries unit and Suffolk's sexual health services

It now has more than 700 General Practitioners and over 100 nurses either directly employed or registered with the company

CONCERNED Crys Rapley said she was pleased that a health watchdog was investigating patient safety at Take Care Now.

Mrs Rapley, 69, was upset by the standard of care offered to her mother, who she didn't want to name, by the company last year and said she believed more checks were needed to guarantee a high quality service.

Mrs Rapley, of Broughton Road, Ipswich, said her elderly father, during the months before her 90-year-old mother's death, had needed to call out of hours on several occasions with what she claimed were mixed results.

She claimed: “The worst experience was the advice given in the early hours of the morning by a doctor. On hearing my mother was crying out in a lot of pain he advised 'give her a cup of tea and put some whisky in it'. She was not visited.''

On hearing of her father's concerns, Mrs Raply arranged for her mother to be taken to Ipswich Hospital where she was diagnosed with an attack of shingles in her head.

Mrs Rapley has since complained to NHS Suffolk. She added: “I am pleased there is going to be a review because the system of ensuring there is always good quality care does not seem to be working.”