In a letter to CCGs this week, NHS England admitted that its guidance had not been 'entirely clear' on the role GP commissioners should play in monitoring the quality of out-of-hours care provided by GP practices that retain 24-hour responsibility for their patients.
The letter pointed out that NHS England expects CCGs to 'assure quality for all out-of-hours primary medical services, including those for which GP practices remain contractually responsible'.
The letter comes just weeks after a report by financial watchdog the National Audit Office (NAO) warned that NHS England had ‘very limited oversight’ and was doing ‘little to monitor performance’ of out-of-hours services commissioned directly from GPs who have not opted out of out-of-hours responsibility.
Many practices retain 24-hour duty
Around one in 10 GP practices remain opted in for 24-hour responsibility for their patients.
The NAO report warned there was ‘little assurance’ that the out-of-hours GP services commissioned by NHS England were providing a service of acceptable quality or value for money.
NAO auditor general Amyas Morse said: ‘Although some clinical commissioning groups are achieving value for money, this is not the case for the commissioning of all out-of-hours GP services.
‘NHS England has much to do to help secure improvements throughout the system and to increase its oversight of the out-of-hours GP services it commissions directly.
The NHS England letter to CCGs said: 'For the avoidance of doubt, we would like to clarify that CCGs should, as part of their delegated responsibilities, assure the quality of all out-of-hours providers. A significant number of CCGs are already fulfilling this role through your overall assurance of out-of-hours services.'