Hackney GPs are to appeal decision to extend contract for out of hours services with private provider

BMJ 2013; 346 doi: (Published 04 February 2013) Cite this as: BMJ 2013;346:f733
  1. Zosia Kmietowicz
  1. 1BMJ

GPs in the London borough of Hackney are furious that the primary care trust cluster for the area has refused to allow them to opt back in to providing out of hours care and has instead extended the contract to the private provider Harmoni for a further nine months.

They said that they would appeal the decision and have confirmed that GPs are ready to start delivering out of hours care to their patients from 1 April through the Hackney Urgent Healthcare Social Enterprise.1

The cluster, NHS North East London and City, told GPs on 29 January that they could not opt back in to providing out of hours care, as they wanted to, because the move may contravene European Union rules on competition. This was despite the fact that the cluster’s procurement panel had approved the switch.

Instead the cluster has extended the contract held by Harmoni to provide the out of hours service in Hackney until January 2014, to give the Hackney and City clinical commissioning group time to deliver a proper procurement process. At that time the social enterprise would be able to bid to take over the running of the out of hours service from Harmoni.

Deborah Colvin, a GP from the Lawson Practice, Hoxton, who had been helping to establish the enterprise, said that she and other doctors had been working on the social enterprise for 18 months.

Colvin said that local GPs were “very angry” about the decision. “They [the PCT cluster] have seen our business case; they know who is going to run it [the service],” she said.

In a statement the cluster’s board said that it “recognises the work carried out by local GPs in drawing up proposals to manage the service from a local social enterprise. This work will not be lost, as they will be able to bid to operate the out of hours services in the procurement process.

“We appreciate this delay is disappointing for local GPs and many residents, but we hope that progress can now be made in a process that will ensure the best service is provided to local people.”

However, Colvin said that a temporary contract could have been awarded to the social enterprise, after which the procurement process could have gone ahead. This is exactly what happened in October 2010 when Harmoni took over the contract to run the out of hours service from Camidoc, a not for profit organisation led by doctors.

She said that one of the objectives of the Health and Social Care Act was to hand control back to doctors but that by denying GPs the chance to opt back in this simply was not happening in Hackney.

Colvin also questioned whether the decision to award the contract extension to Harmoni was in the best interests of patients, given reports of high rates of dissatisfaction with the service.2

“The talk from the board about ensuring the best service for local people feels like a lot of hot air,” Colvin told the BMJ. “There is no reason the board couldn’t have given the contract to the social enterprise as an emergency and then done a mini-procurement again. It is disgraceful that they care more about risk [of non-compliance with EU legislation] than patients.”


Cite this as: BMJ 2013;346:f733