The newly formed Care Quality Commission (CQC) is to examine services provided by the company Take Care Now after being made aware of concerns. The inquiry comes after the case of Daniel Ubani, a German doctor providing out-of-hours cover who administered ten times too much of the painkiller diamorphine accidentally to a patient, while providing NHS out of hours medical cover in Cambridgeshire last year.

A spokesman for the CQC said that it had been alerted to other concerns about Take Care Now and would be deciding on the scope of the inquiry they would undertake. The company has four contracts for out-of-hours cover for the National Health Service in Cambridgeshire, Suffolk, Great Yarmouth and Waveney and Worcester.

At the same time an independent treatment centre, operated by Nations Healthcare, has been warned by the CQC that they will continue “to cast a very bright light” on its services to ensure it continues to improve. Eccleshill ITC in Bradford did not have criminal records bureau checks in place on all its staff, despite being warned about it after an earlier Healthcare Commission inspection in January. That investigation was prompted by a coroner’s verdict of misadventure aggravated by neglect on a patient who died after gall bladder surgery. The patient suffered blood loss after the operation but the inquest heard that blood had to be driven from a nearby hospital, and some surgical equipment was not available at the centre.

This case highlights the need for commissioners to have systems in place to assess the competence and performance of contractors at all levels. The impact of a serious untoward incident goes well beyond the prospect of meeting a claim for damages. In the present climate the reputational risk itself could put serious pressure on the organisation. You need to ensure that you can answer questions that will be posed by the CQC.