An investigation into Cornwall's out-of-hours GP service has declared it "possible" that its performance may have been "overstated" because managers routinely altered negative data.
In a highly critical report into the service managed by private company Serco, the Care Quality Commission (CQC) has today issued a 14 day ultimatum for answers on how improvements will be made.
Following a number of surprise visits, the independent health watchdog said the firm was failing to meet four essential targets, including staffing shortages which left one doctor working a 13-hour double shift.
Ian Biggs, deputy director of CQC in the south, said their inspectors had witnessed how Serco managers would "routinely" alter daily performance reports which show whether call response time targets were met.
Managers would correct individual records which suggested the service was failing if the entry was known to be incorrect for any reason, the report said.
The company explained that it would take too long to check whether calls registered as within target were correct.
However, inspectors raised concerns after examining a small sample of data and finding two examples of failed calls which had been wrongly classified as achieved.
Mr Biggs said: "We haven't found that the company have been deliberately misleading the people of Cornwall about their performance, although quite clearly the system of monitoring performance is unreliable," he said.
"When the managers correct the data, only the calls that would improve the overall daily performance are subject to checking and reclassification, so that must raise questions about the accuracy of the data.
"It is possible that the performance of the provider may be overstated in their reports.
"We have been told that the problems of wrong classifications have been known to Serco for about four years – so it is puzzling that this has not been resolved before now."
As well as monitoring issues, the CQC found that Serco had not provided enough qualified, skilled staff, which at times left doctors working long hours and patients given a slow service.
It was also told to improve patient safeguarding and staff training.
Paul Forden, managing director of Serco's Clinical Services, said the service consistently received top ratings.
Positive changes had already been made in three-quarters of the issues raised, he added, with the fourth expected to meet required standards with a month.
"Patient safety and wellbeing is our first priority," he said.
"We have taken and will continue to take any criticisms extremely seriously and we have fully cooperated with the CQC in their investigation. We are confident that we will be able to fully satisfy the CQC that we are meeting all of the standards required when they next visit the service."
