healthmedicinet

“My personal feeling is that at times it has been unsafe,” the source said. “It’s
a dereliction of duty. Everything is secondary to meeting budget.

“Patient care is compromised, employee care compromised. “It’s an edict
from on high.

“They have thinned rotas down to a bare minimum.”

A spokesman for Harmoni said: “The clinical staff employed by Harmoni are all
self-employed GPs or advanced nurse practitioners who work on flexible
contracts.

“Harmoni has in place some of the most robust interviewing procedures in this
field to ensure the communications skills of GPs who work for us are of a
high standard.

“On very rare occasions, and only after consultation and agreement with our
commissioning colleagues in North Somerset that the service remained
clinically safe, we have run an overnight shift with a very experienced
advanced nurse practitioner providing the first point of contact with a GP
available on-call to support with any advice needed GPs available to support
if a home visit was necessary.”

The spokesman added that “there are some occasions where filling all the
planned GP rota slots is a challenge”.

“Even when this is the case we ensure we are providing a service which is
clinically safe and our service is constantly closely monitored by NHS
commissioners to ensure this is the case,” he said.

Harmoni has contracts across the country, and when asked if this happens
elsewhere, the company answered: “Highly trained and experienced advanced
nurse practitioners are a valued, important and often-used part of our
workforce across the country.

“Harmoni imposes strict criteria on our recruitment of advanced nurse
practitioners, selecting those with advanced qualifications and additional
skills sets suitable for the urgent care environment.

“Advanced nurse practitioners do have certain limitations on the care they can
provide such as with very young children and palliative care. Therefore, on
the occasions when they are the first point of patient contact, we ensure
there is always covering support available from a GP.”

A Department of Health spokesman said: “It is a legal requirement for the NHS
to make sure the right, high quality out-of-hours services are in place for
patients in their area.

“If this is not happening it is totally unacceptable and we expect the local
NHS to take action immediately to improve their services.”