Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the practice is closed for educational sessions.
32-497: Harmoni was a provider of outsourced healthcare services including Out-of-hours services , NHS 111 , prisoner healthcare and IT services. It provided NHS services to more than eight million people in the UK. It was created by a merger of ECI healthcare investment 's WCI Group’s IT services division and the Harmoni GP cooperative. It was the most successful out-of-hours provider in winning
64-452: A commercial deputising service in allowing doctors to have adequate time off duty, but control is exercised from within the health centre.” The Royal Commission on the NHS in 1979 reported that commercially organised deputising services had grown rapidly over the last ten years and about one third of all GPs made some use of them. They received complaints that deputies lacked personal knowledge of
96-601: A contract to run out-of-hours services in Cornwall but NHS Kernow, the Clinical commissioning group , reached agreement with the firm to end the current contract at the end of May 2015 – 17 months early. Zafash Medical Services Limited provides services in central London on a commercial basis outside the NHS. Practice Plus Group runs the service in Gloucestershire. Services including Now Healthcare and Push Doctor provide
128-752: A lifestyle choice. Now, you often find GPs who specialise in out-of-hours … typically, a shift rota is available on the internet and the GP is able to sign up to whatever shifts they want to work." A study by the National Audit Office in July 2014 of people in England found that 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; that 26% had not heard of out-of-hours GP services, and 19% had not heard of NHS 111 . Provision of out-of-hours services
160-606: A nationwide commercial GP service that runs out of hours, weekends and bank holidays. Urgent Health UK is a federation of Social Enterprise Unscheduled Primary Care Providers to which many of these organisations belong. According them in 2018 social enterprises were delivering out of hours services to 67% of patients in England, with an annual contract value of £294 million. Since 2008 the proportion delivered by NHS organisations has declined from 30% to 18% and that delivered by commercial providers dropped from 30% to 15%. Average annual funding per patient for social enterprise contracts
192-557: A plan that all primary care groups would become trusts by 2004. This was said to be a break with the market culture of the previous government, replacing GP Fundholding with a corporate culture that emphasises partnership and collective responsibility. The National Health Service Reform and Health Care Professions Act 2002 required the Secretary of State for Health to establish strategic health authorities (SHAs) and primary care trusts (PCTs) to cover all areas in England and abolished
224-627: A preferred, named doctor were more pressing issues. There was variation in demand for weekend opening with the highest demand in Windsor, Ascot and Maidenhead where some 28.1% of patients wanted surgeries open on Saturday but it was lowest in Wigan, where only 13.9% did. In October 2014 GPs complained that the NHS 111 service had not been inspected by the Care Quality Commission and that it could jeopardise
256-576: A single Primary Care Group controlling a unified budget for delivering health care to and improving the health of communities of about 100,000 people. A PCG was legally speaking a subcommittee of a district health authority . As part of the implementation of the NHS Plan 2000 PCGs were transformed into primary care trusts. 17 trusts were established in April 2000, a further 23 in October 2000, and 124 in April 2001 with
288-481: A single telephone call, routed in the first place through NHS Direct and passed, where necessary, to the appropriate provider of out-of-hours services in that locality.” eventually developed into NHS 111 and influenced the formulation of the 2004 GP contract. Until the 2004 contract most GPs provided care for their patients outside those hours either themselves, or as part of a GP Co-operative. The total amount earmarked for Out of Hours duties including Night Visit Fees
320-420: A successful deputising service before 1973: “. . . twenty general practitioners group together to provide a highly organised system of out-of-hours health care … The telephone” (at the health centre) ”is permanently staffed and the patients are not involved in the delays of a post office diversion system. In the evening the telephone is answered by an experienced registered general nurse who can give advice where it
352-474: A variety of forward-thinking services to suit modern lifestyles, including greater use of Skype, email and phone consultations for those who would find it easier." Results from the GP Patient Survey, an independent poll run by Ipsos MORI on behalf of NHS England showed that extending opening hours and weekend opening were not a high priority for many patients. Long waits for appointments and failing to see
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#1733104466044384-542: Is a particular problem in remote locations. The Western Isles are an example of a remote area where new models of care are being trialled, with Community Unscheduled Care Nurses being deployed for patients who need to be visited at their place of residence. David Cameron introduced plans to enable "hard working people ...to see their GP seven days a week and out of office hours" in September 2013. This promised access to GPs from 8am-8pm, and on Saturday and Sunday and to "test
416-402: Is appropriate. In the event of a visit being required the nurse is able to contact the doctor on duty by radiotelephone. . . . . The patient’s previous notes are readily available to the nurse in the health centre and can be passed on to the doctor on duty. . . . Control of the system is exercised by a sub-committee of the health centre committee of management. The system thus has the advantages of
448-505: Is £7.62, for NHS organisations £8.10 and commercial organisations £8.22. Central Nottinghamshire Clinical Services was placed in Special Measures after an inspection by the Care Quality Commission in May 2015. In February 2017 Pulse (magazine) reported that 10 of 104 providers who responded to a Freedom of Information request admitted that there had been overnight and weekend shifts over
480-496: The Care Quality Commission . The contract for General medical services which most GPs work to requires practices to be responsible for their patients between 8 am and 6.30 pm from Monday to Friday. In some cities commercial deputising services were set up employing doctors to cover the out of hour’s period, paid by the practices in the area but these weren’t viable in much of the country. Woodside Health Centre in Glasgow established
512-657: The GP co-operative, City and Hackney Urgent Healthcare Social Enterprise in October 2013. Out-of-hours service Most Out-of-hours services in Scotland and Wales are provided directly by Health Boards. In Northern Ireland they are provided by the Health and Social Care Trusts. In England they are commissioned by Clinical Commissioning Groups , usually working together, as the contracts often cover large areas. Out-of-hours providers in England must be registered with, and are regulated by,
544-688: The Transforming Community Services initiative. On 12 July 2010, the then Secretary of State for Health, Andrew Lansley , unveiled a new health white paper (which eventually became law as the Health and Social Care Act 2012 ) describing significant structural changes to the NHS under the Conservative and Liberal Democrat coalition government . Among the changes announced , PCTs were to be abolished by 2013 with new GP-led commissioning consortia, clinical commissioning groups , taking on most of
576-654: The 95 health authorities which has been created under the Health Authorities Act 1995 , moving most of their functions to the PCTs. PCTs held their own budgets and set their own priorities, within the overriding priorities and budgets set by the relevant strategic health authority, and the Department of Health . They provided funding for general practitioners and medical prescriptions; they also commissioned hospital and mental health services from NHS provider trusts or from
608-673: The G-Docs out-of-hours cooperative in Grampian became Scotland’s first out-of-hours general practitioner service, financed by 200 GPs who each paid a monthly subscription. The Carson Report published by the Department of Health in 2000 proposed quality standards which would apply not only to deputising services and Out-Of-Hours cooperatives but also to individual GPs & practices providing their own cover. Carson's proposal for “A new model of integrated out-of-hours provision ... accessed by patients via
640-528: The Government’s NHS 111 contracts in 2012. It was sold in 2012 by ECI Partners to Care UK for about £50 million. The company claimed that it made no profit out of the out-of-hours market. The Chair of Camden's Health Scrutiny Panel said the company won the Out-of-hours contract for Camden not on quality, but on price. They described the service as a loss-leader . It lost the contract for Hackney to
672-479: The commercial sector. Prof John Campbell said the research showed that the poorest scores by providers were seen in the commercial sector. Harmoni HS Ltd was a major provider of primary care, including out-of-hours services, which started as a GP co-operative and is now owned by Care UK . Take Care Now had contracts for services in Cambridgeshire , Suffolk , Great Yarmouth and Waveney , and Worcester . It
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#1733104466044704-531: The government announced that the number of strategic health authorities and primary care trusts would be reduced, the latter by about 50 per cent. The result was that, as of 1 October 2006, there were 152 PCTs (reduced from 303) in England, with an average population of just under 330,000 per trust. After these changes, about 70 per cent of PCTs were coterminous with local authorities having social service responsibilities, which facilitated joint planning. Providing responsibilities were gradually removed from PCTs under
736-847: The past year with no GP cover. The biggest number of sessions were in Peterborough and Tower Hamlets. In June 2019 it was reported that the service at Vale of Leven Hospital had been closed 50 times since December 2018 as no GPs were prepared to work. Primary care trust Primary care trusts ( PCTs ) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May 2011, they also provided community health services directly. Collectively PCTs were responsible for spending around 80 per cent of
768-429: The patient and access to the medical records, contacting the service could be difficult, and that deputies were slow in responding to emergencies In 1994 after minor changes to the GP contract many groups of doctors got together and formed cooperative organisations sharing the out of hours calls between a large number of GPs on a rota basis. A minimum of about 40 GPs were needed to set up a successful cooperative. In 1996
800-423: The private sector. Many PCTs used the naming style of "NHS" followed by the geographical area, to make it easier for local people to understand the management of the NHS locally. PCTs were managed by a team of executive directors headed by a chief executive . These directors were members of the trust's board , together with non-executive directors appointed after open advertisement. The chairman of each trust
832-484: The responsibilities they formerly held. The public health aspects of PCT business would become the responsibility of local councils. Facilities owned by PCTs would transfer to NHS Property Services . Strategic health authorities would also be abolished under these plans. Following widespread criticism of the plans, on 4 April 2011, the Government announced a "pause" in the progress of the Health and Social Care Bill to allow
864-400: The safety of Out-of-hours services. In April 2015 Exeter Medical School used data from the official GP patient survey in England to score different types of providers out of 100. On speed, confidence and overall experience, scores from patients seen by commercial providers were lower. The score out of 100 for overall experience was 73 for NHS providers; 72 for not-for profit providers; 69 for
896-408: The subject of major complaints and of failing to employ sufficient doctors. By 2013 most of the co-operatives had converted to social enterprises. Many of the co-ops were involved in the provision of contracts to deliver NHS 111 services. According to John Horrocks, chief executive of Urgent Health UK, "It's not the same as it used to be, where everyone took their turn in a co-operative. It's more of
928-455: The total NHS budget. Primary care trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012 , with their work taken over by clinical commissioning groups . In 1997 the incoming Labour Government abolished GP Fundholding . In April 1999 they established 481 primary care groups in England "thereby universalising fundholding while repudiating the concept." Primary and community health services were brought together in
960-401: Was a non-executive director. Other board members included the chair of the trust's professional executive committee (PEC) (elected from local general practitioners, community nurses, pharmacists , dentists etc.). The financial budgets, and much of the agenda, of PCTs were effectively determined by directives from the strategic health authority (SHA) or the Department of Health . In 2005
992-440: Was an average of just under £6000 per GP per year. The new contract passed the responsibility for organising out-of-hours services from individual doctors to the primary care trusts . Practices could opt out of the provision of out-of-hours services and lose the £6000 and most did. Some PCTs worked with the GP co-operatives, but some gave the contract to a commercial provider, commonly Harmoni or Serco both of which have been
Harmoni - Misplaced Pages Continue
1024-1177: Was taken over by Harmoni. Care UK Clinical Services Limited now provides unscheduled care to over 15m patients. It runs out of hours services in Rotherham, Hampshire, Harrow, Hillingdon, Merton, Islington, Kingston, Wandsworth, Camden and Ealing. IC24 provides services in East Sussex, Brighton & Hove, Kent, East Surrey and West Sussex. Virgin Care provides services in Croydon Medvivo provides services in Wiltshire. Nestor Primecare Services Limited provided out of hours services in Mid Essex, Dudley, Sandwell, Heart of Birmingham, South Birmingham, Wolverhampton, Herefordshire, Scarborough, Sunderland in England and Abertawe Bro Morgannwg and Carmarthenshire in Wales but withdrew from its contracts in November 2018. Serco had
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