Death Inquiry Slams Stand-In Care

The government’s shake-up of GP out-of-hours care has been criticised after an inquiry into a woman’s death. Penny Campbell, 41, from Islington, north London, died of septicaemia in 2005, after consulting eight different doctors over the four-day Easter break.

The report into her death said her care was flawed and there was confusion over the role of night and weekend cover which no longer lies with GPs.

The government said NHS trusts had been asked to review their own arrangements.

Ms Campell, a mother-of-one from Islington, died after developing complications from a routine surgical procedure carried out in March 2005.

Over the Easter bank holiday weekend, she spoke to eight doctors working for Camidoc, the local GP out-of-hours service, before going to A&E.

None of the doctors identified the septicaemia that led to her death.

An inquest in October 2006 concluded the non-recognition of the condition contributed to her death.

The latest inquiry said a major systems failure by Camidoc – over passing on information – meant each call was treated as an individual episode.

And it added Camidoc’s roots as a small co-operative meant that it was not fully prepared for its rapid transformation into a major provider of out-of-hours care.

The report said Camidoc should improve its governance and the four PCTs which pay for the service – Camden, City and Hackney, Haringey and Islington – should develop action plans to address the failings identified.

It also called on the doctors involved to reflect on the case.

But the report said the failings should also be seen in the context of the changes to the GP contract in 2004 which allowed doctors to opt out of weekend and night care.

In total, nine in 10 GPs opted out of the responsibility.

A variety of arrangements are being used across England to provide out-of-hours cover, but the most common is a co-operative, like Camidoc, which are not-for-profit organisations set up by GPs to cover regions.

The inquiry called on the government and the rest of the NHS to learn from the lessons of the case.

It said the perception of out-of-hours care as a “holding bay” until full GP care resumed needed to be addressed.

And it warned there was “policy confusion” over whether an out-of-hours service was for urgent or unscheduled care.

Ms Campbell’s partner, Angus MacKinnon, said a return to the old arrangements where GPs had responsibility would be “better than the existing system”.

But the Department of Health said: “This is a tragic incident and we need to learn all lessons we can for the future, but let’s be clear this case is not about the change we introduced in out-of-hours provision.”

But a spokeswoman added: “We have asked PCTs to review their arrangements for how clinicians relay information to each other and where necessary to change their contract arrangements with providers.”

A spokesman for Camidoc said: “We accept and will deliver all of the recommendations, many of which we are already in the process of implementing.”

And Rachel Tyndall, chief executive of Islington PCT, the lead commissioner for Camidoc, said the NHS trust would learn the lessons.

“There were failings in her care and the systems to guarantee quality.”