Bedfordshire Clinical Commissioning Group has been accused of misleading GPs and the public over whether patients in a community based dermatology service run by a private healthcare provider are always seen by specialist consultants.
Optum has admitted one incident where a doctor was incorrectly described as a consultant when they were not on the specialist register held by the General Medical Council. It has also been forced to change its information for GPs and marketing leaflets.
A former Bedford Hospital consultant, Barry Monk, who works privately in the area, said he had seen at least two letters with names of doctors not on the specialist register. He accused the CCG of a “lack of candour” over the service. Dr Monk became aware of the issues after patients, unhappy with the service, paid to see him privately and provided him with copies of the letters they had received.
In August Bedfordshire CCG signed a three year deal with Optum, formerly UnitedHealth, to run what was described as a new “consultant led” community dermatology service.
All dermatology referrals from local GPs go to the service instead of into secondary care. There are four levels of service with the third being described as “community intermediate services”. The contract specifications say patients at this level will be seen by a consultant dermatologist working alongside teams in community clinics.
Bedfordshire CCG said in a letter to Dr Monk this did not mean it expected every patient contact to be with a consultant.
In November the group asked Optum to review all of the letters sent to patients to ensure doctors describing themselves as consultants were on the GMC specialist register.
Optum accepted there had been one incident where a doctor was wrongly described as a consultant and blamed this on an incorrect template letter being used.
Following a review of marketing information to GPs, the CCG also asked Optum to make “minor amendments” to the description of the service and two leaflets it was using. The CCG has not said what these changes were.
In a letter sent to Bedfordshire CCG accountable officer Paul Hassan in January, seen by HSJ, Dr Monk wrote that he had “serious concerns” over the CCGs “apparent lack of candour”.
He said: “The CCG was instructing GPs not to refer patients to Bedford Hospital, but instead to refer them to doctors in the community who although calling themselves ‘consultant dermatologists’ were no such thing, not having the qualifications to be eligible to be on the specialist register.”
Dr Monk also raised concerns over the supervision of the service by its medical director consultant John Ashworth, who is based in Cheshire, saying: “He has a full time job 150 miles away, so it is not clear in what sense these doctors are to be ‘supervised’ when doing specialist work for which they are not qualified.
“I am disturbed that the CCG has attempted to brush [off] serious concerns about the service that it has commissioned as if it was a mere technicality.”
Optum declined to comment to HSJ and referred enquiries to the CCG.
Thomas Wilson, director of contracting and performance for Bedfordshire CCG, said: “We are confident that Optum and its main subcontractor Community Outpatients have robust systems of clinical governance and supervision in place and that they are delivering the service that [the CCG] has commissioned from them.”