A whistleblower claims an out-of-hours GP service covering 250,000 patients in parts of Somerset is using senior nurses when doctors cannot be recruited to work the shifts.
The firm, Harmoni, regularly employs advanced nurses to work eight-hour overnight shifts covering districts of up to 150 square miles, the whistleblower has told a national newspaper.
In times of extreme staffing shortages, there has been just one advanced nurse practitioner working overnight in North Somerset.
– The whistleblower (speaking to a national newspaper)
Working for Harmoni was like taking a loaded gun and sitting with it because at some point it's going to become so unsafe it's going to go off.
My personal feeling is that at times it has been unsafe.
It's a dereliction of duty.
Everything is secondary to meeting budget.
Patient care is compromised, employee care compromised."
Harmoni also holds the contract to run the new NHS 111 helpline number in parts of Somerset and Wiltshire.
Bath & North East Somerset Clinical Commissioning Group has delayed implementing the service due to technical issues.
Harmoni handle calls to the 111 number in North Somerset and then pass the information to a company called BrisDoc, which makes the visit to the patient's home.
– Spokesman for Harmoni
The clinical staff employed by Harmoni are all self-employed GPs or advanced nurse practitioners who work on flexible contracts.
Harmoni has comprehensive measures in place to ensure team members take sufficient breaks.
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."
A new contract for providing out -of-hours GP services for Bristol, North Somerset and South Gloucestershire was awarded to a different service provider, BrisDoc, last month.
– Spokesman for the Department of Health
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."