Primary care trusts failureOut of hours care not hitting government targets

05 May 2006

Many healthcare trusts can't prove they are offering good quality out-of-hours care to patients, according to a new report.

A surgeon looks down upon a patient

The National Audit Office (NAO) found less than 10 per cent of primary care trusts (PCTs) can show they meet government targets on assessing patients within 20 minutes of receiving an urgent out-of-hours call.

Most GPs opted out of the providing out of hours care - designated as care between 6.30 pm and 8 am on weekdays and all day and night at weekends - in 2004, and PCTs took over in 90 per cent of cases.

But the NAO report said the new system had caused a wide range of problems when it was implemented, with some patients suffering long delays waiting for their calls to be answered.

It said a lack of expertise and time meant preparations for the handover were 'patchy' but there was no indication that patient safety had been compromised as a result of the handover and that organisations were now 'beginning to deliver a satisfactory standard of service.'

Confusion among PCTs

It also noted that patient satisfaction levels were 'generally good', but said a survey carried out showed that one in five patients were dissatisfied with the care they received.

There was also confusion among PCTs over whether out-of-hours services should be restricted to urgent care or should respond to any request for care from the public.

Which? Principal Policy Adviser Frances Blunden said: 'If PCTs are confused how do they think the patient feels? How does the consumer know what is regarded as urgent?

'If you have a sick child or elderly relative then you want to know that you can get prompt and appropriate treatment. If services do not adequately meet people's needs for a prompt response and reassurance, then they will just go to A&E; where they know they will get medical attention without too much delay.

'If the government is serious about trying to reduce high demand on A&E; or 999 ambulance services it needs to encourage PCTs to focus more on commissioning out-of-hours services that are truly patient-centred and designed to meet all aspects of their needs.'

Better and speedier

Health Minister Lord Warner said the report showed the NHS was on the right track and that there were high levels of patient satisfaction.

But he said the commissioning of services could have been 'better and speedier in some places' and the government would work closely with the NAO.

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