Out-of-hours GP services face overhaul after report exposes poor NHS checks

The move comes as a coroner yesterday recorded a verdict of unlawful killing at an inquest into the death of David Gray, 70, from Cambridgeshire, who was given a huge overdose of a painkiller by a German doctor.

A report, ordered by Ministers in the wake of the tragedy and amid other concerns about night-time and weekend GP services, found NHS trusts were failing to check references and properly assess doctors' clinical skills, or even their competence in English.

It said: "We discovered that most providers did not make an assessment of the clinical skills or competence of their clinical staff."

The report made 24 recommendations for change, which primary care trusts (PCTs) have been ordered to act on immediately.

Its authors said the quality of care in many areas was "good" but "we acknowledge that the quality of services varies unacceptably and that there are providers and commissioners who need to improve to prevent those occasions where the care offered falls far below that which is acceptable".

Patients Association director Katherine Murphy said: "The dangers were common knowledge. It has taken countless cases of unnecessary tragedy for families in the UK to get to this."

Shadow Health Secretary Andrew Lansley said Labour had taken responsibility for out-of-hours care away from GPs in 2004.

"GPs should be put back in charge of out-of-hours services and should be collectively responsible for commissioning it," he said.

"They are best placed to ensure patients get the care they need, when they need it."

Health Minister Mike O'Brien said all PCTs would be required to meet new national minimum standards on out-of-hours care.

"It's clear that GPs do not want to go back to the situation that was failing before 2004," he said.

"Out-of-hours has been something that PCTs have not focused on heavily. I think they will now, thank god."

Doctor in overdose tragedy 'must face UK trial': Page 5; Comment: Page 12.