Quality | 2009.06.10
NHS watchdog investigates locum
Inquiry into \'exhausted\' GP who killed David Gray with diamorphine extends to others treated by NHS contract firm
The NHS watchdog will tomorrow announce that its inquiry into the case of a foreign doctor who accidentally killed a man on his first UK shift will involve other cases where patients may have suffered harm.
The Care Quality Commission says further incidents involving the same company that hired the German doctor in the "tragic" case of 70-year-old David Gray have been identified by NHS bodies.
The review of out-of-hours GP services contracted from Take Care Now (TCN) comes after the Guardian revealed how the GP, Daniel Ubani, killed Gray in February last year with an overdose of diamorphine.
The doctor, who was hired through a locum agency, said he had been exhausted by his trip from Germanyand confused about a painkilling drug for which he prescribed a massive overdose.
It is understood that the investigation by the commission, promised last month, could take months.
The spotlight will fall on TCN\'s management and how it handled phone calls to the out-of-hours services, as well as its response to calls, its recruitment, supervision and training of staff, and its supply and prescription of medicines. The investigation will also examine quality checks by the NHS trusts commissioning the services, and the way they act on incidents involving patient safety. Patients as well as current and former TCN and NHS staff will be interviewed by telephone.
TCN has contracts for GP cover for primary care trusts (PCTs) in Cambridgeshire, Suffolk, Great Yarmouth and Waveney, and Worcestershire. It also provides doctors for the East of England ambulance service, which is responsible for out-of-hours services in the area covered by the South West Essex trust.
Christine Braithwaite, the head of investigations and enforcement at the commission, said: "We need to make sure that both Take Care Now and the PCTs that commission its services have identified the problems, learnt lessons from them and made robust improvements as a result. Our number-one priority is the safety of patients, and we will be looking closely at the contributory factors to the care provided in specific cases, as well as thoroughly examining the current systems in place.
"If we find areas of concern that require immediate attention, we will not hesitate to use our powers to make sure the safety of patients is not compromised."
TCN\'s chief executive, David Cocks, said the commission was "the correct body to review the systems relating to the provision of out of-hours GP support and to make informed recommendations, if appropriate, to the benefit of patients and healthcare providers".
Ubani has been given a nine-month suspended sentence and fined €5,000 (£4,305) by German authorities for causing Gray\'s death by negligence, to the dismay of the patient\'s family, who wanted a prosecution in Britain. Medical experts have also questioned the treatment Ubani gave two other patients.
In Worcestershire, the NHS trust had called in independent experts to investigate services provided by TCN before the publicity about the Cambridgeshire case. Local GPs had concerns about the speed at which patients who rang for out of hours services were prioritised and treated.
Suffolk PCT has conducted a consultation on improving out-of-hours services, while the Cambridgeshire trust is about to do the same as part of a reorganisation that was planned before the furore broke over Ubani.
For more information, please visit
http://www.guardian.co.uk/society/2009/jun/09/daniel-ubani-gray-gp-overdose
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