Patients 'put at risk' by out-of-hours care service

The review – the latest to raise problems with night-time and weekend NHS care – details problems with hi-tech equipment used by staff working for West Yorkshire Urgent Care Services serving two million people.

It was ordered after GPs raised concerns about "reliability, usability and patient safety" in connection with technology known as SystmOne.

The urgent care network is operated by NHS Direct, private firm Care UK and not-for-profit group Local Care Direct and went live in April last year.

But it immediately ran into difficulties with complaints by patients that calls were not being answered and of long waits for visits by out-of-hours doctors.

And today's report warns the overall NHS-funded service "does not functionally appear compliant" with rules laid down in 2006. Author David Carson, of the Public Health Foundation, said: "Inquiries and interviews with staff in all three providers identified a range of issues relating to information flows, updating of information in a timely fashion (and) availability of information to front-line clinicians."

The study, leaked to Pulse magazine, said it was not obvious using the technology if patients had called before in the previous 72 hours, an issue raised from earlier cases including that of London journalist Penny Campbell, who died from multiple organ failure in 2005 after consulting eight doctors over the course of four days. Doctors treated each of her calls as a fresh inquiry because they could not access each other's notes.

Dr Carson also said GPs had to read tiny laptop screens using a very small font leading to a "significant risk" of errors in data entry or recording of medical details. Doctors were hand-writing notes that should have been computerised and some records had still not been entered after a week.

"When one considers the volume of calls being handled I have no doubt there is a risk of significant harm to patients."

A statement from SystmOne manufacturers TPP claimed there were errors in the report.

"Where problems were identified TPP was pleased to be able to provide rapid improvements to the software," it said. "We are continuing to work with the service commissioners and the providers to deliver system enhancements."

A West Yorkshire Urgent Care Services spokeswoman said: "Dr Carson's review showed there were some issues that we needed to tackle to make sure that we reduced clinical risk.These were issues which we had already been working on. Some of them have already been resolved, and an action plan is in place to make sure that we complete all outstanding actions promptly."

Mark Napper, clinical lead for the service commissioners, added: "Extra measures have been put in place to ensure patient safety until these outstanding actions are completed."