Out-of-hours monitoring vital, watchdog warns

By Alex Stevenson

Monitoring of out-of-hours services must be improved across the NHS, a review of the death of a 70-year-old man has found.

The Care Quality Commission published an interim report calling on all NHS trusts to improve the ways they monitor levels of care provided by external providers.

It follows the 2004 decision of most GPs to opt out of providing out-of-hours care. Most trusts chose to establish contracts with private contractors to fill the gap this created.

Daniel Ubani, a locum doctor from Germany working for provider Take Care Now, accidentally gave 70-year-old David Gray a fatal overdose of diamorphine in February 2008.

He received a suspended nine-month sentence in Germany and the case prompted the current review by the CQC.

The commission then visited the five primary care trusts which use out-of-hours services from Take Care Now. While trusts monitored response times, they did not consistently look at the quality of care provided.

“Although we are still in the early stages of our enquiries, we believe this may point towards a national problem,” CQC’s chief executive Cynthia Bower said.

“We are therefore encouraging PCTs across the country to scrutinise in more detail the out-of-hours services they commission.”

The CQC’s final report is expected to be published in early 2010.