New controls on GP out-of-hours care follows coroner’s verdict

New controls on GP out-of-hours care follows coroner’s verdict

04 February 2010

The Department of Health in England has announced tighter controls and more robust skills and knowledge testing for GPs offering out-of-hours services.

This follows a coroner’s ruling in the case of patient David Gray who died of an overdose of diamorphine administered by German GP Daniel Ubani.

The new measures come out of a report General Practice Out of Hours Services published by the Department of Health today. All of the report’s 24 recommendations have been accepted and all Primary Care Trusts (PCTs) will be expected to act on them as a matter of urgency.

PCTs have already been issued with interim guidance to assist them in complying with their obligations to ensure all doctors admitted onto their list of approved out of hours GPs have a satisfactory knowledge of English. The DoH claims the new measures go even further, introducing stronger national minimum standards and producing a model contract for PCTs to use when procuring out of hours services.

PCTs will also be expected to regularly review their performance management arrangements for their out-of-hours GP services, ensuring they are robust and fit for purpose. Strategic Health Authorities should also oversee how PCTs manage the performance of out of hours GP providers.

But a comment from the GMC today seems to question whether the new measures go far enough. Speaking of the coroner’s verdict in the Ubani case, Dr Niall Dickson, Chief Executive of the General Medical Council (GMC), said:

"This has been a terrible tragedy and an avoidable one. The sad case highlights serious failings in a system that should protect patients.

"One of those failings is that as the UK regulator we are not allowed to test the language and competence of doctors from the European Union as we do with doctors from other parts of the world.

"We have taken advice from leading Counsel and it is absolutely clear that in general, European applicants may not be required to undertake a language test. This is absolutely the case for doctors who hold European primary medical qualifications. The combination of EU law and domestic legislation (the Medical Act 1983) effectively excludes testing of a European applicant's language proficiency.

"The current situation is not acceptable. We are in continuing discussions with the Department of Health to resolve this situation."

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