Provision of out of hours care including NHS 111 contracts and out-of-hours GP services are popular for private companies. However, over the last few years there have been multiple examples of terminations and failures of contracts from various private companies in this service.
In early September 2017, Primecare, which had been awarded one of the first integrated NHS 111 and GP out-of-hours services contracts, announced that it would be handing back the contract to the NHS.
Initially this was to be in July 2018, but then in late September 2017 the company invoked a clause in the contract that meant it only had to give three-month notice; Primecare left the contract in December 2017.
The contract began in January 2017, but after only seven months, Primecare was placed in special measures after its services in East Kent were rated "inadequate" by the Care Quality Commission. Failings included not assessing risks to patients' health and not having enough staff to meet patient needs.
Central Nottinghamshire Clinical Services
In May 2016 Central Nottinghamshire Clinical Services, the private company in chare of out of hours services across the East Midlands, announced it was filing for administration.
It stopped its services in Leicester, Leicestershire, Rutland and north Nottinghamshire and they were transferred to another provider. The company also ran care home support services and these were transferred to Nottinghamshire Healthcare Trust.
Care UK terminated a contract to provide NHS GP out-of-hours services in April 2015. The contract was to provide care in conjunction with Portsmouth Health Limited (a group of local GPs), however the deal, which began in 2012, proved to be loss-making and so Care UK ended its involvement before the end of the contract.
Similar tensions around costs-cutting were reported to be at the heart of difficulties experienced by the out-of-hours company Harmoni (now owned by Care UK) in London. In 2010/11 several GPs complained about an aggressive cost reduction agenda that they felt put their patients at risk.
In December 2013 Serco announced that its contract to provide out-of-hours care in Cornwall for Kernow CCG would end 18 months early.
The contract had been dogged with controversy; Serco had to admit that some of its staff falsified data to make the company's performance appear better than it was and whistleblowers had raised concerns about poor staffing levels.
The Public Accounts Committee reported the service to be falling "unacceptably short" of essential standards of quality and safety. In 2013 Serco unsuccessfully tried to sub-contract the work to Devon Doctors, the GP consortium that had failed to win the original bid; Serco had won the bid as it was cheaper.