A FIRM that provided out-of-hours GP care for Fenland patients has been slammed for its “systemic failings”.

The Care Quality Commission (CQC) ruled that Take Care Now (TCN) had “limited understanding of the service” when Dr Daniel Ubani killed David Gray on his first shift in the UK.

The NHS regulator also said TCN doctors gave two patients overdoses of diamorphine before the Manea resident’s death but failed to investigate what happened.

German medical authorities now want to bring disciplinary action against Dr Ubani, saying he has been treated too “sympathetically” in his homeland.

The Nigerian-born clinician has been asked to attend a fitness for practice hearing in Westfalen-Lippe on August 18.

CQC chairman Dame Jo Williams said: “Take Care Now failed on many fronts.

“Not only did it ignore explicit warnings about the use of diamorphine, it failed to address deep-rooted problems across its entire out-of-hours service.

“This had tragic consequences for Mr Gray.”

The report added that TCN staffing levels were “potentially unsafe” and that unfilled shifts combined with a lack of clinical cover could have compromised patient care.

TCN also lost the confidence of local GPs, who rated it as “poor” or “very poor”, and Primary Care Trusts did not have “robust arrangements” to share details about poorly performing clinicians.

However the report acknowledges: “NHS East of England has since taken significant action to address issues about these services.”

Dame Williams added: “Take Care Now is no longer in operation but the lessons of its failure must resonate across the health service.”

Dr Ubani was called to Mr Gray’s home on February 15 2008.

He administered the patient with 10 times the recommended dosage of the drug and was later struck off in the UK by the General Medical Council (GMC).

A court in Germany gave him a nine month suspended prison sentence for death by negligence but he is still free to practice in his homeland.