MPs accuse Serco’s out of hours GP service of a culture that led to cheating and dishonesty

BMJ 2013; 346 doi: (Published 24 April 2013) Cite this as: BMJ 2013;346:f2672
  1. Adrian O’Dowd
  1. 1London

The culture at a privately run, out of hours GP service in Cornwall was one that seemed to encourage staff to “cheat” and to feel uncomfortable with telling the truth, MPs have claimed.

Managers of Serco appeared before the House of Commons Public Accounts Committee on 22 April as part of the committee’s inquiry into out of hours GP services in Cornwall, which are provided by the company for NHS Kernow, the clinical commissioning group for Cornwall and Isles of Scilly.

Serco has been the subject of various reports critical of its service from the NHS regulator the Care Quality Commission and the National Audit Office.1 2 3 These were initially prompted by claims by several whistleblowers that the service was understaffed and was altering data to ensure that it met targets.4

Despite repeated assurances from three managers appearing before the committee who said that the quality of services had improved significantly, MPs were not convinced that everything was working well now for the company.

The committee’s chairwoman, Margaret Hodge, the Labour MP for Barking, told the Serco managers, “This leaves me with the strong feeling that the culture within your company was one where for some reason or another people felt they had to cheat and where they did not feel comfortable in telling the truth about levels of service that was being offered by your company.”

Jeremy Stafford, chief executive of Serco in the United Kingdom and Europe, said, “What I can say quite clearly is that that isn’t the company I know, and if I look at the points that you have raised, we take whistleblowing very seriously as an organisation.

“I have been taken aback by some of what has come to light through the press coverage, but rest assured, we take this most seriously, and we are taking a whole series of steps to ensure this couldn’t happen again in the future.

“We have benchmarked whistleblowing systems within the business, and they are used extensively.”

MPs asked whether the service was now fully staffed with healthcare advisers and doctors, given previous criticisms of shortages in these areas.

The witnesses said that they now had 63 healthcare advisers in post and planned to recruit more to cope with a growth in demand for the service. There were also now more GPs.

The Serco managers told MPs that the health sector accounted for around £300m (€350m; $460m) worth of the company’s £2.4bn earned annually from working with the UK public sector.

The Cornwall contract, which runs from 2011 to 2016 and is worth an estimated £32m in total, had made a loss of £1m in 2012, and the company said that it did not expect to make a profit until 2014.

Stafford said, “We are focused on making sure that we deliver a good service to the citizens, that we meet our commitments that we have made to the commissioners … and if that means we make a loss, then so be it.”

Hodge challenged the witnesses over a leaked memo, details of which were published in the Guardian newspaper, claiming that staff members had been told how to make changes when they dealt with people who might need an ambulance so that the service could meet performance targets.

She said, “Somebody in the organisation puts out an instruction to deliberately not get people as quickly as they can to an ambulance when they need it, simply to meet your KPI [key performance indicators]. It’s outrageous.”

Serco’s contract director, Louis Warren, also giving evidence, said that this was not true, adding, “We ring an ambulance every time it is appropriate to do so. The memo was written by one of our middle managers, and they were acting in the best interests of the wider health economy.

“Mistakes are made, and how that email was written and what transpired afterwards was regrettable.”


Cite this as: BMJ 2013;346:f2672


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