PERFORMANCE: Cornwall’s Serco run out-of-hours service fell “unacceptably short” of essential standards of quality and safety, the chair of the public accounts committee has said.

Commenting on the publication of a report on the service from the National Audit Office, Margaret Hodge MP said it was “not good enough” that neither Serco nor NHS Cornwall and Isles of Scilly spotted problems with the service including understaffing and falsifying of records.

The problems came to light after whistleblowers contacted the media. A responsive review by the Care Quality Commission last summer found GPs were working double shifts of up to 13 hours due to staff shortages. The following month Serco admitted it had found evidence staff had altered performance records.

The NAO report, published today, found this resulted in performance against seven indicators being inflated, six of which were reported as green when they should have been amber or red. The report noted this did not affect the amount of money the primary care trust paid to Serco.

Ms Hodge said: “Serco needs to raise its game and demonstrate that it is accurate and honest in reporting its performance. The PCT and, from April, the clinical commissioning group need to monitor every heartbeat of Serco’s performance, be watchful for substandard service and take a firm line against poor performance.”

The NAO report also highlighted deterioration in Serco’s performance following the introduction of call triaging system NHS Pathways in May 2012. The number of patients referred for an urgent appointment doubled from 600 in January 2012 to an average of 1,200 between June and October, further increasing the pressure on the service. The proportion of calls answered within 90 seconds fell from 96 per cent in January to 63 per cent in June, only recovering slightly to 68 per cent by October.

NHS Pathways is due to be introduced across the country by 21 March to handle calls received by the new NHS 111 service. NHS 111 will take on all calls currently made to out-of-hours services and NHS Direct but uses fewer clinically trained staff.

The NAO report said Serco now has GPs on hand to “supplement” pathways and recommended all areas carry out a full impact assessment ahead of the introduction of Pathways.

It said: “Serco recognises that it did not fully appreciate the impact NHS Pathways would have on call handling times and that it underestimated how many additional staff would be needed to process calls, particularly in the early days.”

Louis Warren, who manages the Serco service, responding to the report in a statement, said: “Over the last six months the GP out of fours service that Serco provides in Cornwall has been the subject of the most comprehensive scrutiny and exhaustive series of audits possible.

“The NAO report has not only substantiated what the CQC and other reports have already shown - that the service is safe and well regarded by patients - but also confirms that we have taken swift and decisive action in response to the previous CQC report.

“The only outstanding minor issue noted was that we need to take further action to increase the number of health advisors; our recruitment campaign will have this resolved by the end of March.”