Problems with call filtering sytem of privatised service have led to costly rise in A&E attendance, NHS trust board papers show
Problems at the privatised out-of-hours GP service in Cornwall, run by leading government contractor Serco, have led to a costly spike in attendance at A&E, according to board papers before the Royal Cornwall Hospitals Trust (RCHT) this week.
The NHS hospitals trust has failed to meet its target for seeing patients at A&E within four hours in recent months and had ordered a review of the causes of the rise in numbers, which dates back to February.
The board papers blame the introduction by Serco of a new system for filtering patients’ calls to the out-of-hours service in May. Calls are now screened in the first instance by staff who no longer need to be medically trained but use instead a series of computer-generated scripts. Since the system was introduced in mid-May, the number of patients being seen in A&E averaged at 228 per day, compared with 216 in the same period last year.
A Guardian investigation earlier this year uncovered allegations by whistleblowers that the Serco service was regularly so short-staffed as to be unsafe and claims that Serco had manipulated its results where it failed to meet targets.
A damning report by the health regulator the Care Quality Commission (CQC) in July found that the company was failing to meet legal requirements in four key areas, including staffing levels and monitoring of results. Inspectors found the company had been manipulating its daily performance reports by altering entries which showed the service was failing to hit its targets.
The CQC gave Serco 14 days to demonstrate how it would improve the service.
The new answering system, known as Pathways, has been developed by the NHS and promoted by the Department of Health in the hope of relieving pressure on ambulance and A&E services by making sure patients are referred to cheaper primary care where that is appropriate.
The Cornwall primary care trust which awarded the out-of-hours GP service contract to Serco said the impact of the new Pathways system was a teething problem and that it was now working well locally. The PCT ordered an in-depth review of the Serco service and the reliability of its data following the Guardian investigation but declined to comment on it because it was not yet complete.
The chief operating officer for RCHT, Jo Gibbs, said it was working with all parties to tackle the high number of emergency admissions in recent months. “Making sure we provide the right care, at the right time and in the right place for patients needs the co-ordinated effort of all services across the health and social care community.”
Serco said in a statement that it was working closely with other parts of the NHS to implement the new system of patient management as efficiently as possible.