Systemic failure of GP support service 'significant risk' to patient care, GPC warns

Widespread, systemic failures in primary care support services outsourced to a private provider in a deal agreed last year are a significant risk to patient care and have increased costs for practices, GP leaders have warned.

Piles of patient notes awaiting collection (Photo: Dr Irfan Malik)
Piles of patient notes awaiting collection (Photo: Dr Irfan Malik)

GPC chairman Dr Chaand Nagpaul has called for a halt to further roll-out of new primary care support services until they have been properly tested and demanded compensation for practices affected by the problems.

In a letter to NHS England and Primary Care Support (PCS) England Dr Nagpaul said the new service provider Capita appeared to have been ‘considerably underprepared for the level of work and resource required for the roll-out of new services related to patient records transfer, provision of medical supplies, and the reconfiguration of PCS offices’.

The 'systemic failure of several elements of support services' was 'totally unacceptable', Dr Nagpaul said. 'These widespread failures are leading to increased workload for practices, governance risks, direct impact on patient services, and significant cost and disruption to practices and individual GPs.'

Primary care support

Capita was awarded a 10-year £400m contract to provide NHS PCS services from September 2015 after a tendering process. NHS England required the new provider to slash the costs of provision by 40%.

Since GPonline first revealed details of the outsourcing plan in 2013 GP leaders have warned the funding cuts could lead to a worse service for practices.

Last month GPonline reported that piles of medical notes bagged up for transfer were piling up at practices after Capita had failed to collect them.

Dr Nagpaul told NHS England and PCS England that pilot and interim services by Capita had led to ‘significant delays in receiving patients’ records (particularly urgent requests), and increased workload, disruption and expense to practices’.

Some practices, he said, had seen up to 200 records being stored in reception areas while Capita’s subcontractor failed to make pick-ups for weeks.

‘Practices have advised that due to a failure in the provision of medical supplies (such as syringes, needles) and prescriptions stationery, patient services have been disrupted,' Dr Nagpaul said.

GP services disrupted

‘Clearly this presents a significant risk to the care provided to patients. We understand that measures are being put in place to mitigate against the lack of supplies, but often these mitigations increase workload and cost to practices and despite the reassurances we received some weeks ago there does not seem to be improvement.’

Meanwhile Capita’s service centres had been unprepared to deal with enquires from practices about the problems with practice staff ‘left waiting over half an hour for an urgent phone call to be answered or to not receive replies to emails for days’, the GPC chairman's letter warned.

Every practice, said Dr Nagpaul, should receive ‘recurrent recompense for the extra workload related to the new Capita services, in addition to compensation for increased workload and inconvenience caused by the unsatisfactory introduction of these services’.

A spokeswoman for Capita told GPonline: 'We are closely monitoring our operation while the new services are embedding and have arrangements in place to respond and address users’ feedback. We are working closely with NHS England and proactively engaging key stakeholders, including the GPC, so we can continue to refine and improve the service.'

The GPC called for urgent action to determine:

  • Exactly what is being done to resolve and stabilise the service
  • That no further plans will be implemented until they have been thoroughly tested, and proved to be safe, but also acceptable to end users
  • Sufficient numbers of adequately trained staff are available (halting office closure plans if required)
  • Lessons will be learnt, by altering the service specification with Capita and by providing
  • Additional funding support for practices
  • Any current or future PMS reviews should take into account the increased workload when deciding on appropriate levels of funding
  • Any governance breaches should be investigated and NHS England must indemnify GPs who have acted reasonably, but find through no fault of their own, breaches of any CQC or information governance issues as a result of these changes.

Last month, a spokeswoman for Capita said changes it was implementing to the system for transferring patient records aimed to deliver a 'a safer, better service'.

Patient record transfers

She told GPonline: 'As part of the changes to primary care support that NHS England has asked us to deliver, we are moving from a medical records service that varied hugely across the country to a standardised process for every practice.

'There was an initial transition period where collection times were temporarily paused to allow us to transfer the many individual courier services to our new national single supplier. We have now introduced a secure, weekly collection service for medical records for all GP practices across England.'

'A key feature of the national service will ensure that medical records will be fully tracked until they reach their destination. We are currently piloting this approach in one region and when this has concluded we will begin to launch across the country.

'We are continuing to work closely with NHS England and proactively engaging key stakeholders, including the GPC and LMCs, so we can continue to refine and improve the service going forward.'

The Capita spokeswoman said that any practice that has experienced delays with collection of records should contact its helpline for advice.

A spokeswoman for NHS England said: 'Cutting administrative back office costs by 40% has freed up tens of millions of pounds for reinvestment in frontline NHS care, but the vendor swiftly needs to deal with these transition issues so that practice managers are properly supported. We will be holding the vendor to account for doing exactly that.'

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