Published: 16:03, 31 July 2020
| Updated: 16:06, 31 July 2020
A full review into the failings of a private healthcare firm's contracts to run NHS GP and dermatology services has been promised.
South London-based DMC Healthcare has been running doctors' practices in Medway and dermatology services across north Kent.
But last week it revealed it would be handing back contracts for nine surgeries in the Towns and the dermatology contract.
This came after serious concerns about patient safety were raised by Care Quality Commission (CQC) inspectors.
It has not been confirmed what is happening with DMC's local staff and how much money it would have to hand back to the NHS but it is understood negotiations regarding the contracts are ongoing.
In the meantime, emergency measures introduced by the Kent and Medway Clinical Commissioning Group (CCG) mean the affected surgeries remain open and dermatology services have been transferred to an interim provider.
A top CCG official has said there will be an investigation into how the situation went so badly wrong.
Chief nurse Paula Wilkins has apologised to patients for the "sad situation" but insisted bosses are "working incredibly hard to rectify this".
She told KentOnline the review will take a hard look at "the process of due diligence" or whether any "early warning signs could have been picked up".
Ms Wilkins said: "When things go wrong, it's really important that we learn.
"At the moment, our concern is making sure patients are safe. Where patients have come to harm, then a full review will take place.
"All our energy is sorting out today and getting tomorrow right.
"After that we will be doing a full look back at what can be learned."
Medway Practices Alliance (MPA) is currently running the GP services at eight surgeries previously under the control of DMC which was removed from running five of those eight last week and suspended from three others in June.
DMC also said it would be handing back its contract for the Kings Family Practice in Chatham even though it was not subject to any enforcement action from the CQC.
The nine practices have a combined patient list of 49,838 with dermatology services having about 9,000 people registered.
Ms Wilkins added: "We are working with practices and overseeing them at the moment. We've had clinical advisors in all of those surgeries to double check the safety."
No DMC staff are working in any of the eight practices in Medway the company previously ran and for the north Kent dermatology service.
But staff do still remain at the three surgeries in Swale – Iwade Health Centre and the Sheppey clinic – and Albion Place in Maidstone where the company's registration is not affected.
Ms Wilkins said the remaining surgeries run by DMC in Kent "should not" be hit by the same issues seen by the practices in Medway.
'Too early to know why DMC failed'
She said it was too early to comment on why DMC had failed but added she did not feel the company had been trying to cut corners.
"There were certain things they are now putting in place that you may have wanted to see in place a lot earlier," she said.
"I don't think I can say that's because they were trying to cut corners.
"I think it was about things working at small scale organisation and what you need to change as the organisation scales up as opposed to deliberately cutting corners.
"They had an awful lot of contracts and having had discussions, their processes weren't as robust as they should be for the size of the organisation they were growing in to."
She also pointed out concerns the CCG had regarding the staffing model DMC had employed and recognised the firm had a "high number of locum appointments".
Ms Wilkins said: "That doesn't mean locum appointments are a bad thing but whether they had enough of them and we were concerned they weren't employing enough staff for the population.
"Locums aren't bad but if it's your staffing model that's where there's an issue.
"An over-reliance on locums would have been okay if they were there working all the time. It's just how many you have per population."
Patients put at risk across several surgeries
Earlier this month, the CCG stopped DMC from operating St Mary’s Island Practice and its branch surgeries at Gillingham’s Balmoral Healthy Living Centre (green surgery), the Sunlight Centre Surgery, Gillingham, Twydall Branch Surgery and Boots in the Pentagon Centre, Chatham.
This was after inspectors found not enough improvement had been made since a previous visit in January.
Safety concerns included the storage of medicines and fire extinguisher maintenance.
Last month, the CCG suspended DMC for three months from running Hoo St Werburgh Medical Practice and its branches at Lower Stoke and Balmoral Healthy Living Centre (yellow surgery).
There was major issues with the dermatology service with IT problems being cited for patients not receiving notifications of appointments and test results.
Search is on for new provider
In a statement, DMC said it had taken on previously "challenged and troubled" services from the NHS.
But Ms Wilkins dismissed this saying the firm knew what it was taking on when it submitted a bid for the contracts but had not made the required improvements.
"DMC do have a history of taking over challenged contracts so they're not wrong in that," she added.
"But part of taking it over was knowing they were taking that over and were going to put the right levels of governance and change in to make the improvements needed.
"The CCG started working with DMC quite soon after they took over the primary care contract to make those improvements.
"The CCG sent a team of intensive support staff in February because we couldn't see the improvements at the speed and pace we needed them to protect patient safety.
A new long-term provider is now being searched for which Ms Wilkins said they hope will be in place in "weeks to months not months to years".
Negotiations with providers have started to find a new long-term solution for both GP services and the dermatology contracts which will also involve patients.
But Ms Wilkins denied the experience with DMC meant a private provider would not be considered.
"I'm not sure we can say the whole thing is a failure based on one [private] company. I think there are areas across the UK where this does work.
"Legally you have to put things out to tender and that's not a CCG decision about whether an NHS or non-NHS provider can bid for them – that's a government decision and the law."
Helpline set up for patients
The CCG has established a helpline for dermatology patients needing advice.
It is 0300 555 0708 and is open Monday to Friday, from 9am to 6pm.
People using the affected GP practices should call them as normal with any questions.
"They had an awful lot of contracts and having had discussions, their processes weren't as robust as they should be"
The helpline set up for patients received more than 100 calls on the first day it was running.
This has since dropped to some 30 per day with many patients questioning when they would be getting their next appointment.
"A lot of it is around people being concerned about their next appointment and their treatment plan," Ms Wilkins said.
"The true feedback will come when we start seeing people and the service they did receive."
Visit www.kentandmedwayccg.nhs.uk/dmc for more information.