Action follows disputed Carson report

West Yorkshire primary care trusts have moved to back TPP in the wake of the Carson report, which criticised the out-of-hours system used by West Yorkshire Urgent Care Service.

The five PCTs, together with TPP, have issued a joint statement which says that the report from Dr David Carson “did not enjoy consensus amongst the commissioners, providers or TPP.”

In addition, TPP has issued a statement that states that “all the problems the service experienced were due to do with either misunderstandings of how the SystemOne software works, or were not software issues.” It added: “no changes were required to the software.”

Neither statement outlines which parts of the report were contested. However, all the parties have signed up to an action plan agreed as a result of it. The PCTs have also said they were confident that the TPP solution met their requirements.

The Carson report concluded that TPP’s out-of-hours system created “a significant risk to patient health” and left the service in breach of regulations.

It also made a number of other criticisms. For example, it criticised NHS Direct for classifying up to 60% of visits requests as urgent, saying this put “a significant strain” on the system.

The PCTs and TPP said the report listed a number of issues “that had already been identified by the service” and that an action plan was drawn up to ensure their speedy resolution.

It said Dr Carson was content that the action plan that had been agreed would address all the issues in the report.

Dr Mark Napper, clinical lead for urgent care ay West Yorkshire PCTs, added: “TPP worked enthusiastically with us prior to the launch of the West Yorkshire Urgent Care Service to ensure that SystmOne met our requirements.

“We are confident that SystmOne meets our requirements as commissioned and that TPP will continue to work positively with us to make further improvements if and when required.”

The service covering 2.2m patients in West Yorkshire is commissioned by the five PCTs and provided by NHS Direct, private provider Care UK and social enterprise Local Care Direct.

NHS Direct rebutted the report’s conclusion that patients were at risk of harm, although Local Care Direct told EHI Primary Care that it “fully endorses the contents of the report by Dr Carson”. Care UK said it was unable to comment separately from the PCTs.

Helen Young, clinical director and chief nurse for NHS Direct, told EHI Primary Care: “We strongly refute any claims in the report that patients have been placed at risk of harm.

“We firmly believe that the service is clinically safe and we are working closely with the commissioners and the other providers of West Yorkshire Urgent Care to continue to improve the service, working to an action plan that was in place prior to the publication of the report.”

Local Care Direct said the report from Dr Carson “did generate discussion amongst PCTs and providers” but that a joint action plan was drawn up to ensure that the issues identified were quickly resolved.

When asked by EHI primary Care whether the PCTs agreed with the Carson report, they issued the following additional statement: “The PCTs commissioned Dr Carson as a result of his long standing experience of urgent care.

“We are in a joint process with the providers and TPP of implementing functionality at present via a time limited, targeted action plan in order to meet the recommendations in the Carson report.”