§ Alan SimpsonTo ask the Secretary of State for Health what comparative assessment he has made of the impact on hospital emergency services of(a) out-of-hours service cover by general practitioners in (i) Sheffield and (ii) other areas which have chosen not to use an arm's length service provider and (b) the cover provided in (A) Nottingham and (B) other areas using arm's length providers. [184969]
§ Mr. HuttonNo central comparison has been made of the impact of out-of-hours services on emergency services of areas where general practitioners have not opted-out and areas where organised providers, such as GP co-ops, have been commissioned by primary care trusts (PCTs) to provide the service.
As recommended by the independent review of GP out-of-hours services, PCTs should be developing integrated networks of unscheduled care, which bring together accident and emergency, ambulance services, walk-in centres and in-hours services, to meet the full range of patient needs and to reduce unnecessary referrals to emergency services.
There is to be no change to the pattern of provision for 80 per cent. of Nottingham residents already served by the GP co-operative, Nottingham Emergency Medical Services (NEMS) and which have been so for six years. NEMS is an active participant of the local emergency care network and no adverse impact on emergency care has been identified locally.
§ Alan SimpsonTo ask the Secretary of State for Health what steps he is taking to encourage general practitioners to ensure that out-of-hours cover services are supported by appropriate access to patient records and history. [184970]
§ Mr. HuttonThe national quality standards, which all providers of out-of-hours services must meet, include specific requirements that there is rapid and effective transmission of patient data between general practitioner practices and out-of-hours services, a system for transmitting information on patients with special needs from the practice to the provider, and all providers must be able to supply full clinical details of all consultations to the patient's GP practice by the next working day.
This will be further improved through the introduction of the electronic patient record. In Nottingham local providers and practices are establishing systems for sharing patient information. Nottingham Emergency Medical Services, in partnership with the local emergency care network and NHS Direct, has already established a database of important information provided by GPs on the most vulnerable members of their practice population. This is being extended and access to this is being enabled for other emergency care providers.
§ Alan SimpsonTo ask the Secretary of State for Health what comparative assessment he has(a) made and (b) commissioned of patient safety under 895W (i) National Emergency Medical Services cover and (ii) general practitioners running their own out-of-hours service. [184974]
§ Mr. HuttonAll organised out-of-hours providers must meet the national quality standards. The standards, which cover clinical governance, organisational and service standards, and access and clinical assessment, are designed to ensure that patients receive the highest-quality care, and were recommended by the independent review of general practitioner out-of-hours services in 2000.
The national quality standards are currently being reviewed by an expert group, to reflect the new contractual mechanisms in primary care. The new standards will come into effect on 1 January 2005 and from this date all providers of out-of-hours services, including GP practices which choose not to opt-out, will have to meet the quality standards as a contractual obligation.
Primary care trusts (PCTs) will monitor all providers in the delivery of their services to ensure they meet the standards and the strategic health authorities in turn will performance manage the PCTs in delivering these services.