PERFORMANCE: Serious care and accountability failures in an out-of-hours GP service have been highlighted in a report from a London primary care trust.

NHS Croydon’s report into Croydoc found the organisation was effectively controlled by one doctor who, it alleges, took money out of the business without board approval, failed to answer calls and sometimes provided the service for south west London from his home in Norfolk.

Dr Ravi Sondhi is said to have repeatedly failed to answer the phone when on call, taken up to three hours to respond to urgent enquiries and failed to record his actions afterwards.

The inconsistency in the service saw call handlers have to lie to patients about why a doctor had not called them back, the report said.

Dr Sondhi was suspended in December 2009 and a General Medical Council hearing is pending.

Croydoc ran out-of-hours services in Croydon, Sutton, Merton and Kingston and covered nearly a million people. It was active in the area from 1995 to 2010.

As well as being chair of Croydon’s professional executive committee, Dr Sondhi was Croydoc’s chair, operations director, finance director and medical director.

The report said: “It is unusual to find an organisation providing NHS out-of-hours care which is so controlled by one doctor”.

“Final accountability for ensuring the safety of this service rested with the board,” it stated. “Most board members were aware of the effect [Dr Sondhi’s] behaviour had on patients, staff and the effectiveness of the service, but did not challenge or seek external advice.

“Conflicts of interest were not recognised by the board. However, in most respects the members of the board were untrained for this role.

“They did not accept that they were also accountable for the safety and effectiveness of a multi-million pound organisation providing out of hours care for a population of 950,000.”

The report also found fault with the PCT for failing to monitor the contract.

NHS Croydon commissioned a review of the organisation in 2005 “which made wide-ranging recommendations” but it “does not appear to have taken any follow-up actions”.

Harmoni now provides services in Kingston while social enterprise PatientCare 24 runs those in Croydon, Sutton and Merton.

NHS South West London medical director Dr Dave Finch said: “It is plain that the other board members, all GPs themselves, did not understand their governance responsibilities, possibly out of misplaced loyalty towards a colleague. 

“There are lessons here for all commissioning bodies, particularly as clinical commissioning groups begin to take wider responsibilities for commissioning services in the NHS.“

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