Serious failings by a GP have been revealed in a report  by NHS commissioners into a service providing out-of-hours GP care to nearly one million people in south west London.

They relate to Dr Ravi Sondhi, a GP who used to have a practice in Croydon and who at one time was Chairman, Medical Director, Operations Director and Financial Director of Croydoc, which provided the out-of-hours GP service to patients in Croydon, Kingston, Merton and Sutton, using a panel of local GPs.  Croydoc was an independent company managed by GPs.

GP out of hours work in Croydon, Merton and Sutton is now undertaken by a new organisation, PatientCare 24.

The report, by NHS Croydon (Croydon Primary Care Trust, which has since been assimilated into NHS South West London), found that Dr Sondhi:

• Withdrew over £100,000 from Croydoc without authority
• Provided the out-of-hours service for south west London patients from his home in Norfolk
• Repeatedly failed to answer telephone calls when he was on call.  On one occasion 114 calls were logged to his phone overnight
• Took between 1.5 and 3 hours to respond to urgent calls (the standard target was 20 minutes)
• Failed to record his actions following out of hours calls, with over 250 “unresulted” calls listed
• Repeatedly cancelled his shifts without warning
• Took substantial sums of money from his own practice staff, who believed he was investing it on their behalf.

Dr Sondhi has subsequently been declared bankrupt.  He has been suspended from practising on an interim order by the General Medical Council (GMC).  A hearing into his conduct by the GMC is awaited.

The report finds that the Croydoc Board failed to take action and the commissioning bodies (the Primary Care Trusts) failed satisfactorily to monitor the Croydoc contract.  This is accepted by the NHS bodies. However, as soon as NHS Croydon became aware of these failings in December 2009, both the Chief Executive of Croydoc and Dr Sondhi were suspended.

The PCT reported Dr Sondhi to the GMC and launched the investigation.

Croydoc was closed as a company and the out-of-hours service Patient Care 24 took over providing the out of hours service. This organisation has strong governance arrangements and the PCT have assured themselves that the Patient Care 24 service is providing good care to patients.

Dr Dave Finch, Joint Medical Director, NHS South West London said: “This report reveals a shocking series of failings by one GP who apparently managed to dupe his professional colleagues whilst letting down his patients and claimed payment for work he did not do.  I want to reassure patients that this incident is about out of hours services that were provided in 2009.  There is now a new organisation called PatientCare 24 providing out of hours services.  We are confident that this organisation is providing a safe and effective service to patients.

“There are lessons here for all commissioning bodies, particularly as Clinical Commissioning Groups begin to take wider responsibilities for commissioning services in the NHS. And that is why we are planning to circulate this report throughout the service so that these new organisations can ensure the governance arrangements are there to ensure a rogue operator cannot fix the system.

“Being a good clinician is not enough. GPs are amongst the best-trusted people in our society for good reasons. We want to ensure they are trusted for their management as well as their medical skills. GPs are committed to their patients and patient safety and that is why GPs are the right people to be in charge. But they must not ignore the need to be vigilant and be prepared to challenge their colleagues in the interest of the best patient care.

“What Dr Sondhi did was wrong and local GPs and the NHS are very angry and shocked about the findings of this report.  All patients should be able to feel confident that a call to an out-of-hours GP service is going to be dealt with effectively and professionally. In very many cases that did not happen.  We are confident that Patient Care 24 is providing an effective service to patients, but we take our responsibility to monitor its contract extremely seriously in the light of this report.”

As with all health services we value the feedback from patients and their families and if anyone has a specific patient experience to discuss they can call NHS Croydon PALS on 020 8274 6333.

Ends

Note for Editors:

A copy of the report can be found here.

• Dr Sondhi (Dr A) the principal protagonist, was suspended by Croydoc in December 2009, by the PCT from the Performer’s List in December 2009 and the GMC on 11 January 2010 (refreshed in November 2011).  Dr Sondhi was also PEC Chair of Croydon PCT and resigned from this post as soon as these allegations were brought to light.
• The Chief Executive of Croydoc was suspended in December 2009 and has since left the organisation.
• Other GPs named in the report have also been subject to an NHS Croydon GP Performance Panel Review and the report has been sent to the General Medical Council for review.
• Dr B was the subject of a hearing before the GMC in March 2011 for an unrelated incident, and was erased from the Medical Register.
• NHS Croydon GP Performer List action was instigated against Drs D, E and J.  For Drs E and J there was no case to answer.
• The allegations against Dr D will be considered by the NHS Croydon Performance Panel at the end of January 2012.
• PatientCare 24 now provides the out of hours GP service in Croydon and Sutton and Merton.
• Harmoni took over the provision of the GP out of hours service in Kingston on 1 July 2011.  Harmoni was founded in 1996 as a GP co-operative called Harrow Medics On Call Inc.  It is commissioned by more than 20 NHS organisations, looking after more than eight million patients across the country.
• All GP on CCG Boards will be trained in corporate governance and this is a national requirement before they can become authorised.
• Dr C was the Croydoc Board Director who first raised this issue with the PCT.   There are no performance matters concerning Dr C.
• Management of the out of hours contract is now robust: contract review meetings monitor standards against national requirements, complaints are rigorously assessed and there is full scrutiny of rotas.  Patient Care 24 performance is sound.
• Key recommendations for the supervision of out-of-hours provider are included within the report.  Commissioners in South West London rigorously monitor the governance arrangements of for the out of hours service.

For further information, please contact communications at NHS South West London on 020 3458 5717 or email media@SWLondon.nhs.uk