Primary care trusts have been told to review the way they oversee their arrangements for out of hours GP services to “ensure they are robust and fit for purpose”.

The recommendation is one of a series made to improve out of hours care published by the Department of Health today.

The report, following a review of out of hours care by national clinical director for primary care David Colin-Thomé and Royal College of GPs chair Steve Field, said there was unacceptable variation in how out of hours services are commissioned, delivered and monitored by PCTs.

Other recommendations in General Practice Out of Hours Services include:

The Department of Health should issue guidance to PCTs to assist them in making decisions about whether or not a doctor has the necessary knowledge of English.

The Department of Health should develop and introduce an improvement programme for PCTs to support their commissioning and performance management of out of hours services. Out of hours providers should consider the recruitment and selection processes in place for clinical staff to ensure they are robust and that they are following best practice.

Strategic health authorities should consider how they monitor action taken by PCTs in response to this report and in carrying out appropriate performance management of out of hours providers.

Providers should cooperate with other local and regional providers (both in and out of hours) to share any concerns over staff working excessive hours for their respective services. All the recommendations have been accepted by the Department of Health.

Responding to the report, Care Quality Commission chief executive Cynthia Bower, said: “It is absolutely critical that NHS trusts put monitoring of the safety of out of hours services higher up their agenda.

“Our work has suggested that the quality of monitoring has been variable.

“The wide-ranging recommendations in this report will help address these concerns. Commissioners and providers of out of hours services across the country must implement them swiftly for the benefit of local people.”