Patient power forces rethink

The Marlborough Medical Practice signed up to the new system a month ago. It meant that when the George Lane surgery was closed, patients were told to ring a central call centre run by the private medical service Primecare.

Primecare's own 'qualified clinicians' the words used by the company on its website would filter the calls, either giving advice by telephone or deciding whether the patient should see the doctor on call in the area or visit the Minor Injuries Unit at Savernake Hospital.

But patients began to complain of unacceptable delays, saying the system was long winded and inefficient and that they were kept waiting for telephone calls that never came.

Parents with sick children in particular were upset that they could no longer ring for a walk-in appointment with the nurses who staff the popular minor injuries unit from 7am to 10pm, seven days a week. Instead the nurses had to follow the new procedure and tell callers to ring Primecare.

On Monday the Marlborough Medical Practice partners issued a statement saying in effect that the performance of the new system was not up to their expectation.

In a joint statement issued by the eight Marlborough GPs they said: "Unfortunately some of our concerns could not be addressed adequately and sufficiently quickly.

"Therefore the partners of the Marlborough practice decided on January 5 to withdraw from the Primecare arrangements with immediate effect.

"We apologise to those patients who experienced excessively long delays during the last month."

The news that the practice was reintroducing its old out-of-hours system was greeted with delight by those who had made complaints. Mother-of-four Linda Bedford, from Beckhampton, said: "Fantastic, that is great news."

Mrs Bedford and her husband Mike were so upset at the response when their four-year-old son Douglas developed an ear infection that they wrote a strongly worded letter of complaint to the Wiltshire Health Authority with a copy to their MP, Michael Ancram.

The ink was barely dry on their letter, however, before the Marlborough practice announced it was withdrawing from the Primecare system.

In their statement the Marlborough GPs added: "The future remains uncertain and we do expect the current arrangements will continue indefinitely.

"Indeed, whilst we were obviously unhappy with the performance of Primecare during the last month, should we be satisfied that our concerns have been fully addressed by the organisation we may reconsider using their services in future."

On Monday the Ramsbury GP practice had been due to join the Primecare service but decided not to in the light of their Marlborough colleagues' experience. Instead the two practices agreed to proceed with a shared out-of-hours cover service due to start on Monday.

Patients from the southern part of the Ramsbury doctors' catchment area will get a shared night cover service with Marlborough GPs. Patients in the northern part of the Ramsbury surgery catchment will get a similar shared service with Swindon GPs.

Patients from Ramsbury will also be allowed to take advantage of Savernake's Minor Injuries Unit.

Before the Primecare system was introduced, months of negotiations took place between practices and the Kennet and North Wiltshire Primary Care Trust with the aim of improving out-of-hours care before the introduction of new GP contracts. It was the trust that negotiated the contract between doctors and Primecare.

Patients in Marlborough were informed of the start of the new Primecare system through the practice's Pick Me Up newsletter.

Writing in it, Dr Jonathan Glover said: "This will mean a little in the way of change to the care you receive and we hope you will find it better as a result."

One major advantage for patients, said Dr Glover, was that with the out of hours cover provided by Primecare there was less likelihood of surgery patients being seen by a tired doctor who had been on night call.