City & Hackney Out Of Hours Services – NOW SAVED!!!!

Update: 27th September 2013 – the fight for City & Hackney Out of Hours Services has been won. Click here to read more.



The subject of Out of Hours Services (OOH) has been in the news a lot recently.  For a history of Out Of Hours Care, please click here.

Hackney Out of Hours service has been provided by the private company Harmoni (now owned by Care UK), under an interim arrangement since 2010.  Up until January 2013, the PCT that commissioned Hackney Health services (at the time) NHS NELC, had been preparing to allow Hackney GPs to ‘opt-back-in’ to giving 24/7 care for their patients from April 1st 2013.

The plan was to move the service from Harmoni to the not-for-profit organisation CHUHSE, which the GPs had formed in response to alleged failings in out of hours care for their patients.

In January 2013, the Section 75 Regulations were announced. That same month, CHUHSE were blocked from taking back 24/7 care in Hackney, as planned.  Instead the PCT, chose to extend the existing provider’s contract for a further 9 months (later 6 months as agreed with Harmoni).

This was surprising since Harmoni had been under increasing scrutiny over its provision of care in the preceding months.  Particularly following the case of Linda Peanberg King, whose baby Axel died under care of the out-of-hours GP service, “Having heard all the evidence in court, I don’t think anyone can have full confidence in Harmoni’s service.”

In a report published May 2013, Harmoni was found by the Care Quality Commission to have been delivering Hackney OOH service without the necessary clinical staff numbers during the time of inspection.  “Our judgement: Overall, there were not enough qualified, skilled and experienced staff to meet people’s needs.”  The Hackney Gazette reported “The company admitted there had been no doctors based at Homerton Hospital on the evening of Easter Sunday, despite being contracted to provide a service when GP practices are closed.”  The article 22nd May 2013 also highlighted the point in the CQC report that, “In fact, figures covering November 2012 to January 2013 show Harmoni failed to comply with the National Quality Requirements (NQR’s) targets of 95 per cent in four separate areas.”

Furious Hackney residents and GPs wanted to know why the plan for CHUHSE taking over out of hours had been changed at the last minute.  The answer was that lawyers for both the PCT and the new CCG had advised that there was a risk that Harmoni’s owners would take legal action if the social enterprise was allowed to take over without a new bidding process.

As the Hackney Gazette explains, the tendering and re-tendering process encourages potential service providers to keep cutting costs, so as to be competitive against rival bids, to the point that it is no longer possible for the winning provider to deliver adequate care.

NHS campaigners are concerned that under the new Health and Social Care Act 2012, and specifically Section 75 regulations, fear of litigation is being put before patients’ care.  Not only do Hackney residents now have to continue with the OOH service, as provided by Harmoni and found wanting by Care Quality Commission, but their worried GPs seem not to be able step in and help without being forced into a costly bidding process that will only ultimately reduce the amount of funds they have available for patient care….whether they win the bid or not!

Worryingly the story of Hackney out of hours services seems likely to be the shape of things to come for all our NHS services.


**City-Hackney Out of Hours Petition** click here

City & Hackney Coalition to Save the NHS [now reverted to Hackney & City Keep Our NHS Public] has set up the above petition [NOW CLOSED] with the intention that it should be signed by patients/doctors/public who live in City & Hackney – but it can be signed by people across the whole area served by Harmoni - North Central London, as they are all affected.

Update: 27th September 2013 – the fight for City & Hackney Out of Hours Services has been won. Click here to read more.


(Image by Paul Francis)

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