Britain’s biggest chain of GP surgeries has been accused of putting profits before proper care by getting staff who are not fully qualified family doctors to assess patients.
An investigation by the BBC’s Panorama programme found that Operose Health was using physician associates to undertake appointments because they are cheaper to employ than GPs.
An undercover Panorama reporter also disclosed that at the Operose GP practice in London where she worked as a receptionist there was a severe shortage of GPs and a backlog of clinical correspondence – medical reports, test results and hospital letters – that had not been read for up to six months.
The revelations led one of the NHS’s most senior GPs, Prof Sir Sam Everington, to voice concern about the “massive risk” to patients’ safety and accuse the US-owned firm of profiteering.
Operose runs 70 GP surgeries around England that between them have 600,000 patients.
In its broadcast on Monday, Panorama said physician associates at the unnamed surgery had told its reporter, Jacqui Wakefield, how they were in effect doing the same job as GPs, despite having far less training and experience.
They are meant to be closely monitored by family doctors to ensure patients get high-quality care. But one told Panorama: “You get used like a GP,” and that “sometimes I hardly ever see a GP; when I first started it was more, now I hardly speak to them at all.”
After watching Panorama’s footage, Everington said he was worried that physician associates had said they were not getting the supervision they needed. “They’re clearly articulating it but they’re not getting it. And that’s a problem.”
On the backlog of medical correspondence, Everington said: “If a letter destined for the GP is not being acted on for six months, that is a massive risk to patients, both in terms of the development of a more serious disease and them dying earlier.”
He urged ministers to ask the Care Quality Commission (CQC) to investigate the running of the surgery by Operose, which is owned by the US-based private healthcare firm Centene. “They’re putting profits, money, ahead of quality of care. And that will have an impact.”
Wes Streeting, the shadow health secretary, also demanded an urgent inquiry. “The Conservatives have broken their manifesto promise to hire thousands more GPs, but surgeries cannot be allowed to compromise on quality of care as result,” he said.
Panorama claimed that Operose runs its surgeries with six times as many physician associates and half the number of fully qualified GPs as the NHS average.
The company denied Panorama’s claims, including that it was putting profits before patients. It said 97% of its practices were rated “good” or “outstanding” by the CQC. It said it had increased the number of GPs working at the London practice, and across its portfolio of surgeries it had hired 38 GPs over the past year and was recruiting 12 more. Patients received safe care, it said.
David Rowland, the director of the Centre for Health and the Public Interest thinktank, said: “How do you make a profit out of a GP practice or from treating someone for cancer other than to seek to keep costs as low as possible? That will often mean using less staff or less qualified staff with a potential impact on patient care.
“This model of healthcare runs entirely counter to the founding principles of the NHS, which has sought to insulate healthcare in the UK from the profit motive.”
Dr Richard Van Mellaerts, of the British Medical Association’s England general practitioners committee, said: “It is alarming to hear that Operose Health does not believe that it is short-staffed, even though their practices are reported to have far more patients per GP than the national average.
“It is hugely concerning to hear reports that physician associates at Operose Health are being treated as equivalent to GPs and have been working without appropriate supervision.”