This report examines the commissioning arrangements for out-of-hours health care services and the monitoring of contracts by five primary care trusts (PCTs). PCTs control the funding for hospitals and make decisions about the type of services those hospitals provide. They are also responsible for making sure that commissioned services meet the needs of patients and are delivered to appropriate standards. This is the third part of a report resulting from an investigation conducted by the Care Quality Commission (CQC) after the death of a patient treated by a locum employed by Take Care Now (TCN). TCN was commissioned by several NHS PCTs to supply doctors providing out-of-hours care. The report also examines the strategic role of the strategic health authorities and their performance management of the PCTs, and looks at the way that the PCTs administered the performers lists of GPs.
The five PCTs investigated were NHS Suffolk, Cambridgeshire, Great Yarmouth and Waveney, Worcestershire and South West Essex. The CQC compiled the report from evidence including interviews, minutes, surveys, contracts and logs of incidents. They concluded that the PCTs involved did not have a high standard of commissioning or contract monitoring in out-of-hours services. There was a failure to commission appropriate out-of-hours services for the local population and monitor that these were being delivered. The report notes that all the PCTs had begun to improve their commissioning and monitoring arrangements following the incident.