National Audit Office, 11 July 2014
- An examination of performance, oversight and assurance arrangements, and how out-of-hours GP services are integrated with other urgent care.
- NAO "consider that some clinical commissioning groups are achieving value for money for their spending on out-of-hours GP services. We cannot, however, reach the same conclusion about the commissioning of out-of-hours GP services across the board."
- Key findings
- We estimate that out-of-hours GP services cost less now, in real terms, than they did in 2005-06, but the introduction of NHS 111 has made comparisons difficult
- The number of cases being handled by out-of-hours GP services has fallen significantly.
- Most patients are positive about their experience of out-of-hours GP services.
- Out-of-hours service providers are generally responsive, measured against the specified time frames
- The emerging view of the Care Quality Commission is that out-of-hours GP services generally provide ‘safe, effective, caring, responsive and well-led care’.
- The large majority of clinical commissioning groups manage their contracts for out-of-hours GP services actively, including monitoring compliance with national quality requirements.
- Some clinical commissioning groups could manage their contracts better
- Our eight case studies showed that some commissioners had procured out-of-hours GP services competitively when contracts ended while others had rolled contracts forward without competition
- NHS England has very limited oversight of out-of-hours services where GP practices have retained responsibility
- NHS England did little during 2013-14 to assure itself of the quality and value for money of out-of-hours GP services
- The arrangements NHS England is now putting in place are unlikely to provide meaningful assurance.
- The urgent care system is complex and many people do not know how to contact out-of-hours GP services or even that such services exist.
- NHS England has a clear vision to integrate urgent and emergency care services, but has not finalised its implementation plans.
- Public Accounts Committee inquiry on Out of Hours GP Services. September 2014
- This inquiry will challenge the Department and NHS England on their oversight and assurance of out-of-hours GP services, on the performance of the system and on the level of public awareness of out-of-hours GP services.
