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Watchdog calls for better protection for whistleblowers

Crucial role of whistleblowers in Serco GP out-of-hours service

Adrian O'Dowd

Thursday, 07 March 2013

Better protection and transparency are necessary for whistleblowers who played a crucial role in raising concerns about a GP out-of-hours service in Cornwall, according to a report published today.

The report from public spending watchdog the National Audit Office into what happened with the out of hours service run by private company Serco says it was only following whistleblowers’ intervention that the company and the local PCT took action about concerns with the service.

Since 2006, Serco has provided the out-of-hours service in Cornwall, under a contract with Cornwall and Isles of Scilly PCT. The current contract, which runs from 2011 to 2016, is worth an estimated £32 million.

Among the concerns raised was that Serco had been unable to fill shifts with appropriately qualified staff, with the result that the out-of-hours service was unsafe. A clinical review of the service in June 2012 carried out by the PCT found no evidence that the service was, or had been, “systematically clinically unsafe”.

The NAO report says that during 2012, Serco regularly had insufficient staff to fill all clinical shifts. It also frequently redeployed some GPs, taking them out of cars available for home visits and using them to cover clinic shifts instead.

In July 2012, the Care Quality Commission (CQC) reported that the out-of-hours service did not have enough qualified, skilled and experienced staff to meet people's needs.

When it inspected the service again in December 2012 the CQC found that, although the number of clinical staff had increased, Serco needed to take further action because there were not enough health advisers who handled incoming calls.

Serco has not consistently met the national quality requirements for out-of-hours services set by the Department of Health, said the NAO, which also said whistleblowers had raised concerns that Serco staff were altering data about the performance of the out-of-hours service.

An audit by Serco of every interaction passing through the switchboard between January and June 2012, found that two members of staff made 252 unauthorised changes to performance data.

Whistleblowers' concerns had not been identified by routine management controls or by the PCT itself, said the NAO.

The report recommends that the Department of Health should instruct all NHS bodies to publish their whistleblowing policies in order to help ensure that local policies are transparent, consistent and fully compliant with national policy.

The Department should also make sure local NHS bodies held managers to account if whistleblowers suffered reprisals.

The NAO also recommended the PCT and the CCG should review the contract with Serco to link financial incentives more clearly to achieving essential quality standards.

Serco welcomed the report and Dr Louis Warren, who manages the service, said:  “The NAO report has not only substantiated what the CQC and other reports have already shown - that the service is safe and well regarded by patients - but also confirms that we have taken swift and decisive action in response to the previous CQC report.

“While whistleblowers highlighted concerns last year, I am confident that these issues have been addressed. We now have an outstanding culture and strong levels of staff engagement.”

A joint statement from NHS Kernow and NHS Cornwall and Isles of Scilly, said: “We will review all of the recommendations and ensure these are built in to how we monitor the contract to reinforce the quality standards set out nationally and locally for this service.”

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