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Concern over out-of-hours doctor cover

PUBLISHED: 11:01 13 August 2008 | UPDATED: 21:03 05 July 2010

FEARS have been raised that there are not enough doctors to look after patients at evenings and weekends in parts of the region.

The out-of-hours service for Yarmouth and Waveney has been struggling to get enough staff to cover the shifts.

FEARS have been raised that there are not enough doctors to look after patients at evenings and weekends in parts of the region.

The out-of-hours service for Yarmouth and Waveney has been struggling to get enough staff to cover the shifts. Concerns have been raised by the area's primary care trust which has a contract with the company providing the out-of-hours service.

One GP has said there are times when shifts have gone unfilled, and patients have been prescribed inappropriate medicines. On at least one occasion there has been no on-call doctor based in Yarmouth, and sometimes doctors have been asked to work shifts alone rather than alongside a nurse or emergency care practitioner.

But TCN (Take Care Now), the Ipswich-based independent health-care provider which runs the service, says any staff shortages are covered by putting on extra staff in neighbouring areas. In October TCN took over from Anglian Medical Care, (AMC) run by the East of England Ambulance Trust, which still runs the out-of-hours service in the rest of Norfolk. TCN also provides out-of-hours cover for the rest of Suffolk, East Cambridgeshire and Fenland.

But TCN was paying a lower hourly rate than AMC was paying at the time - around £15 an hour less - which meant that some doctors did not want to work for TCN. Others found they could no longer continue the same shifts, so stopped working for the service. Doctors are regularly sent text messages asking if they can fill in shifts at the last minute - not just in Yarmouth and Waveney but sometimes in Ipswich or Basildon.

One GP, who did not want to be named, said: “There are a couple of patients who have been prescribed drugs that are just not used any more for that particular condition. They are getting doctors who are not as up-to-date as they should be in clinical practice.”

“There are issues with what advice patients are being given. Some are being referred to A&E when they would not otherwise be. Patients report difficulties getting through to speak to somebody.”

James Kennedy, medical director of TCN, said: “The GP rotas were agreed with the PCT prior to TCN being awarded the contract and there have been no changes since. The first two weeks of August do present some problems in terms of holiday cover but we make sure that we are never short of staff by putting on extra cover in neighbouring geographic areas.

“Good clinical practice is something we take seriously and we strongly support and implement evidence-based medicine. We hold training sessions with our GPs and publish guidelines for them on best practice. GPs working for TCN prescribe from a list of drugs that has been agreed with the PCT for the out-of-hours service.”

Concerns have been raised at the PCT's professional executive committee, the minutes of which say “they are desperately short of doctors at certain times”.


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