Out-of-hours GP chiefs defend service and say performance is improving

Left, Judy Oliver, chairman of IC24, and Yvonne Taylor, chief executive of IC24. Picture: ANTONY KEL

Left, Judy Oliver, chairman of IC24, and Yvonne Taylor, chief executive of IC24. Picture: ANTONY KELLY - Credit: Archant

Managers are today insisting the region's out-of-hours GP service is 'improving' and said a broader mix of medical staff was vital to the future of primary care during evenings and weekends.

In an exclusive interview, IC24's chief executive Yvonne Taylor and chairman Judy Oliver defended the under-fire service and praised the 'amazing commitment of the staff'.

Their comments came after this newspaper published staff rotas which showed, on certain nights in January, there was only one GP covering more than 900,000 people across Norfolk and Wisbech at weekends – evidence which IC24 now refutes.

It followed a report published last month by Norwich Clinical Commissioning Group which concluded its inspectors were not clinically assured of the safety of the 111 and out-of-hours GP services.

But Ms Taylor and Mrs Oliver said the company was working hard to improve the issues that had been raised during the first five months of IC24 providing the service.


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In their interview, they said:

An increased 'multi-disciplinary' approach with a bigger mix of medical staff was required to provide the service, rather than relying on GPs.

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Performance was improving with fewer patients calling 111 being referred to A&E.

The company was working with the CCG to improve financial conditions for GPs who volunteered to work for the out-of-hours service.

But they added the company was over-spending on its service in Norfolk and Wisbech, which had caused a deficit.

Former health minister Norman Lamb, the MP for North Norfolk, visited IC24 this week and said the key to improving was for health providers in Norfolk to work more closely together.

Workforce morale

Moving workers from one organisation to another has been difficult for certain members of staff, according to the managers.

When IC24 took over the contract, many staff from the East of England Ambulance Service working within the 111 and out-of-hours services moved across under the Transfer of Undertakings Regulations (TUPE).

'It was always going to be a difficult issue for some staff,' Ms Taylor said. 'If any of them have any problems then we want them to raise their concerns with us.'

She said IC24 worked within a framework for out-of-hours care and she added the CCG recognised that there was 'a sense of improvement following the early stages of transition'.

Performance

IC24 is bringing its waiting times for patients down, Ms Taylor said.

She said patients waiting longer than the maximum target for home-visits could occur when the service was 'massively busy'.

On those occasions clinicians would make a clinical decision on which patients to prioritise.

'Long waits were an issue but that has changed,' Ms Taylor said.

They also pointed to 'validated CCG figures' which showed the proportion of patients sent an ambulance by NHS 111 had fallen from 12.2pc to 11.9pc between September 2015 to January 2016.

Ms Taylor said: 'We're a new service and we're looking to improve.

'We would like to see the figures come down further.'

Solving the GP problem

The managers said they were working with clinical commissioning groups to help GPs who say volunteering to work with the out-of-hours service will cost them thousands of pounds extra in indemnity insurance.

Ms Taylor said one GP had claimed working three shifts per month for the out-of-hours service would cost him an extra £20,000 per year in added insurance costs.

'A national solution may be years away but it's an issue we would like to resolve,' Mrs Oliver said.

Meanwhile the out-of-hours GP service also features staff such as emergency care practitioners, urgent care practitioners, and advanced nurse practitioners.

The managers said a multi-disciplinary workforce was central to its strategy.

Do you have a story about the out-of-hours GP or 111 services? Email nicholas.carding@archant.co.uk

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