Out of hours performance variation to be made public

The Primary Care Foundation, which runs the national out of hours benchmark programme for the Department of Health, is due to publish the third round of its assessments later this month and the fourth round early next year.

Until now, reports have been anonymised. However foundation director Rick Stern told the national Primary Care Live conference in London last week that would end with the publication of the fourth round.

He said: “If you want to drive change and drive improvements, there’s nothing quite like opening it up to public scrutiny… it means people move faster and that’s the point right now.”

The foundation measures out of hours performance for 102 PCTs, using a mix of performance data streamed directly from providers’ computer systems, interviews with managers and patient experience questionnaires.

Anonymous results from the first two benchmark assessments, which looked at the performance, cost and operational processes of out of hours services during average periods of demand, were published in March and November 2009.

They revealed major variation between providers in the percentage of cases identified as urgent, which suggested at one extreme patient safety issues and at the other inefficient systems, said Mr Stern.

The third round compared performance at the peak times of Christmas and New Year.

Mr Stern said: “Although we don’t have the final results out, it shows that although there may be very high demand on key bank holidays actually it’s entirely predictable in every organisation.”

He said many providers prepared for peaks by “staffing up” but this was not always effective. He said: “If you have lots of locums who are coming in just for one day, you’ll probably find it’s actually quite hard to be particularly productive or effective.”

He also said the proposals for GP commissioning and integrating urgent care services provided an opportunity to “rebadge” out of hours care, which had “almost become a term of offence in the national media” due to cases like that of Cambridgeshire patient David Gray. He died in 2008 after an error by locum Daniel Ubani.

Mr Stern said: “There is an opportunity now to take a fresh look at what is a coherent urgent care system.”