VERY URGENT, PLEASE HELP! Texts reveal the desperate staff shortages at privately-run out-of-hours GP services putting patients' lives in danger
Doctors claim that Harmoni, the largest private provider of urgent care services in England, is so short-staffed that it is regularly unsafeInvestigation uncovered desperate texts, begging staff to come to work
Company also alleged to have manipulated its performance data, masking delays in seeing patients and other missed targetsAnd fears that a seven-week old baby may have died due to desperate staff shortages and protocols not being followed
13:31 GMT, 18 December 2012
Patients' lives are repeatedly being put at risk by out-of-hours care provided by a private company, senior doctors have claimed
Patients' lives are repeatedly being put at risk by out-of-hours care provided by a private company, senior doctors have claimed.
They say that Harmoni, the largest private provider of urgent care services in England, is so short-staffed that it is regularly unsafe.
An investigation by The Guardian found the company, which has contracts covering eight million patients across large areas of London and southern England, is also alleged to have manipulated its performance data, masking delays in seeing patients and other missed targets.
There are also claims that a seven-week old baby may have died from a suspected respiratory infection after staff shortages meant he waited four hours to be seen at the Whittington Hospital in north London, where Harmoni runs a clinic.
The newspaper claims that crucial checks are missing from the baby’s file and protocols were not followed.
A second doctor who made a telephone assessment of the child two days later is said to have downgraded his case and failed to record the call. /12/18/article-2249894-16908C57000005DC-200_634x466.jpg” width=”634″ height=”466″ alt=”There are also claims that a seven-week old baby may have died from a respiratory infection after waiting four hours to be seen at the Whittington Hospital in north London (pictured), where Harmoni runs a clinic” class=”blkBorder” />
There are also claims that a seven-week old baby may have died from a respiratory infection after waiting four hours to be seen at the Whittington Hospital in north London (pictured), where Harmoni runs a clinic
HARMONI: THE LARGEST PROVIDER OF CARE SERVICES IN ENGLAND
Harmoni is the largest private firm
providing out-of-hours services and the winner of 12 NHS contracts to
run the new non-emergency 111 health phone lines Last year it had
revenues of 100m from the NHS.
It was set up in 1996 as a co-operative
of west London GPs delivering out of hours care. It initially had 104
members; today, it is the largest provider of Primary Care Services in
the UK with over 300 GP shareholders.
Last month, the firm was sold for
48million to Care UK in a deal to create a new private health concern
that could treat 15 million patients.
Its website states that it delivers
‘excellent, high-value patient care on behalf of the NHS for over eight
million patients across England’, adding: ‘Our ethos is to “treat
patients as family” and to “treat staff as we would want to be treated
ourselves”. This drives our behaviours and values across the
NHS Direct employs 3,000 staff, of which 40 per cent are trained nurses. But the 111 number will be staffed by call centre handlers with just six weeks' training.
In a statement given to MailOnline, a spokesperson for the company said: ‘Harmoni categorically refutes that our out-of-hours services in North Central London have been or are currently short staffed, or that our North Central London service is unsafe.
'Our safety record, incidents, complaints, response times to patients and rota fills all show that the service is safely run.
‘As an organisation, we will never compromise clinical safety and our performance is reviewed on a daily basis. At no point has it been the case that there were no overnight clinicians available to see patients or to make home visits.
'At no point has there been only one clinician triaging for the whole of the London service. At no point have our commissioners raised concerns about the safety of the service, or suggested that Harmoni has been in breach of our contractual agreements.’
In one notorious case of an out-of-hours doctor blunder, pensioner David Gray died after locum Dr Daniel Ubani gave him 10 times the recommended maximum amount of diamorphine to treat pain in his kidneys.
The German doctor had failed an English test for one primary care trust, so had simply applied to work at another.
Following his father's tragic death, Dr Stuart Gray, had called for all doctors to undergo checks on their clinical competence.
After Dr Ubani was struck off in 2010, the British Medical Association, the General Medical Council (GMC) and former Health Secretary Andrew Lansley all rushed to condemn the loophole in EU law that meant the language skills of doctors trained in Europe could not be tested before they practised in the UK.
Records show that coroners' courts and the GMC have since dealt with dozens of cases around the country in which the services have been involved in the deaths of patients, including at least eight in one year.
OUT-OF-HOURS DOCTOR WAS TOO DRUNK TO TREAT MY MOTHER, CLAIMS DEVASTATED DAUGHTER
Multiple inquiries: Dorothy Seecoomar, 81, died 40 hours after being in the care of a doctor who was intoxicated, according to claims
Agnes Seecoomar claims her mother Dorothy, 81, suffered unnecessary pain and suffering in her final hours because a doctor sent by Harmoni was 'drunk' and unable to control her oxygen supply.
As a result, the frail pensioner struggled to breathe.
It is alleged the doctor arrived 'incoherent' with bloodshot eyes, and phoned a hospital medic for help but appeared not to understand his instructions.
The following day she was admitted to hospital, and she died 24 hours later on August 17.
Following complaints by the hospital medic and Dorothy's daughter Agnes, Harmoni spent more than two months investigating the doctor.
He left the company last week although the organisation's internal inquiry 'found no indication of any alcohol or drug abuse'.
Ms Seecoomar, a teacher from West London, said her mother had suffered unnecessary distress and pain in her final hours.
She told MailOnline: 'My mother suffered because her breathing was becoming more laboured. This could have been alleviated. Any competent doctor would have seen that she was not getting enough oxygen.
'This doctor was incoherent and his eyes were severely bloodshot. It wasn't just me, two of my mother's carers were there at the time.
'My mother was using quite a noisy oxygen concentrator. He said: “Is she on oxygen” I said: “Are you ok doctor”, because clearly he wasn't.
'He called the registrar at St Georges hospital and obviously couldn't answer his questions, he was rambling, so I took the phone and spoke to the registrar myself and I said, “look this man is incapable and I'm frightened”.
'My mother remained in discomfort. I hoped they would send somebody else after I had reported this doctor as being drunk.
Dorothy Seecoomar meeting Conservative MP Justine Greening in Putney two months before her death, having discussed disability transport issues previously. Ms Greening has since offered support to her daughter Agnes
Ms Seecoomar added: 'The experience with the doctor was frightening. People think we still have an NHS – but we don't, we have commissioners and providers. The providers are increasingly private companies whose primary concern is profit.
'It seems to be a competition to see who can provide healthcare at the lowest possible cost.
'This raises huge questions about quality and accountability as illustrated by what happened to my mother.
'The reality is that we a National Health Service in name only.'
NHS South West London, the primary care trust which contracted Harmoni to provide out-of-hours care, has launched an inquiry.
Last month, Joanne Hollins-Cooper, 31, took her two-year-old daughter Jessica to the NHS walk-in centre in Stoke-on-Trent after a nasty fall. The centre is run by Harmoni on behalf of the NHS.
Doctors examined the arm and diagnosed it as just a bruise and advised her to give her daughter Calpol.
After three days of no improvement in Jessica’s arm the worried mum took her to A&E at the University Hospital of North Staffordshire for a second opinion.
The young toddler underwent a series of x-rays which showed that she had shattered her arm in two places either side of her elbow.
OUT OF HOURS: THE
CHANGE THAT SUITED GPS BUT ROBBED PATIENTS OF PROPER CARE
The standard of out-of-hours care has been under scrutiny since 2004 when a
new contract enabled GPs to opt out of evening and weekend duties. Now only one
in four works out of hours. The majority have transferred their responsibility
for out-of-hours services to primary care trusts (PCTs), many of whom
commission private companies such as Harmoni.
But an investigation by the Mail earlier this year found that out-of-hours
GPs are being left to care on their own for up to half a million patients.
Cost-cutting NHS chiefs are routinely assigning
just one family doctor to districts that stretch over hundreds of square miles.
A third of primary care trusts, which manage GP services, have slashed night
and weekend spending over the past 12 months.
Many trusts have since outsourced the cover to private firms who hire locum
– or temporary – doctors to fill the shifts.
Using the Freedom of Information Act, the Mail asked every PCT in England a
series of questions about out-of-hours cover. Of the 90 that responded, 35 had
slashed their out-of-hours budgets in the past year, on average, by 10 per
cent. And 11 trusts employed only one doctor at night to cover between 180,000
and 535,000 patients.
In Cornwall, some nights saw one GP looking after 535,000 patients. In
mid-Essex just one doctor is was in charge of 370,000 between 7pm and 8am.
And after axing one of its two doctors, north-east Essex had the same cover
for the 325,000 patients on its books.