13 GP practices to close in single county (Pulse: 6 December 2016)
Plans are underway to close 13 of the 18 GP practices in Fermanagh, Northern Ireland, leaving patients having to travel '30 to 40 miles' to see their GP, the GPC has warned.
The proposals are under development with two practices already having closed recently, and four more closing in the next few months.
This is worse than had been previously feared, when it was reported that a third of the practices in the county would close, due to the retirement of potentially a third of the 66 GPs in the rural region.
With no GPs available to fill the slots, it has been predicted that three-quarters of Fermanagh’s practices will close within five years. ...read More.
16,000 patients set to lose their GP practice over holiday period (Pulse: 29 November 2016)
Some 16,000 patients will lose their GP practice over the holiday period, as five practices are set to close across England.
Four practices, with a combined patient list of 10,700, are due to close in Lincolnshire on 16 December.
The Burton Road, Pottergate, Arboretum and Metheringham surgeries had been managed on a temporary basis by Lincolnshire Community Health Services NHS Trust since previous provider Universal Health Limited went into liquidation this summer.
Universal Health said the practices became financially unviable due to recruitment problems, which had left them increasingly dependent on locum doctors, with NHS England running an unsuccessful tender for the APMS contract. ...read More.
'Domino effect' fears as GP practice closes after third provider walks away (GP Online: 28 November 2016)
An MP has called on NHS managers to resolve problems with primary care in her constituency after the announcement that a practice will close just a year after a new provider took over.
The 5,000-patient St Martin’s practice in south Bristol will close in January after the provider Crest Family Practice handed back its contract.
Crest is the third provider in three years that has said the practice is unsustainable.
The original GP partners at the practice are understood to have handed back their GMS contract two years ago because of workload pressures and recruitment problems. ...read More.
Relentless GP workload is a threat to our patients' safety, says RCGP (Royal College of General Practitioners: 25 November 2016)
Professor Helen Stokes-Lampard has responded to a new survey out today from the British Medical Association which highlights the relentless workloads in general practice and the danger this is posing to our patients' safety.
She said: “This echoes much of what the College has been saying for some time now – the relentlessness of the workload in general practice is a threat to our own health and our patients' safety.
“GPs will see a total of 1.3m patients today alone, and rising patient demand means GPs are carrying out more consultations than ever before - currently 370m a year and 60m more per year than even five years ago. ...read More.
GP urgent home visits to ease A&E crisis (The Telegraph: 25 November 2016)
GPs are under pressure to provide emergency home visits to ease the crisis in overstretched A&E departments, NHSdocuments reveal.
Local doctors groups are being asked to establish “A&E Delivery Boards” and to draw up rotas of medics able to respond to 111 requests for urgent care at home.
The boards are ostensibly responsible for easing winter pressures, but the new NHS England best practice guidelines state the measures should remain in place all year round because of the unprecedented demand on hospitals.
Last month a Daily Telegraph investigation revealed that patients are being forced to wait for up to nine hours in ambulances because of the gridlock in A&E departments. ...read More.
GPs decry Capita's privatised backup services as 'shambles' (The Guardian: 14 September 2016)
Family doctors have criticised the “shambles” that has ensued after the firm Capita was handed a £700m contract to provide important backup services to GP surgeries across England.
GP practices have been hit by a host of problems with patients’ medical records and they have begun suffering shortages of syringes, “fit notes” for patients to give to employers and pads on which to write prescriptions since Capita took over last year.
The British Medical Association has criticised Capita sharply for presiding over “multiple failures” in the support it gives England’s 8,000 GP practices.
In some cases, GPs have had to hold their first appointment with a new patient without their medical records to guide their decision-making, because Capita has not transferred them in time. Even some urgent requests to process records quickly because a patient had a medical emergency have not been acted upon. ...read More.
Out-of-hours services 'broken' as single GP regularly covers 370,000 patients (Pulse: 8 September 2016)
Out-of-hours services in Northern Ireland are on the verge of collapse, with individual GPs regularly having to cover populations of 370,000 overnight on their own, GPs have warned.
Those in the South and West are being hit the hardest and are almost at the point of having to close completely, RCGP NI said.
Dr Frances O’Hagan, who is chair of Southern LMC chair and works for the out-of-hours service, described the service in the South as ‘broken’.
She said one GP was left to cover a population of 406,000 patients - although the health board claimed the figure was 369,000 - spread over a large geographical area, rather than the three required on 12 overnight shifts in August....read more
NHS child mental health services are failing the next generation, say GPs (The Guardian: 4 July 2016)
Up to four in five children with mental health problems are being denied access to treatment they urgently need in some parts of England, NHS figures show.
Overall six in 10 children and young people across England do not receive treatment for problems such as anxiety and depression, despite the risk of them coming to harm as their condition worsens.
The new data has renewed fears that vulnerable under-18s are suffering the effects of increasing rationing of psychological help on the NHS, despite high-profile government pledges to improve the service for children.
Family doctors and mental health campaigners voiced concern at the figures, which were obtained by the GP website Pulse. Dr Dominique Thompson, a GP in Bristol who specialises in young people’s mental health, said the figures showed that NHS children and adolescent mental health services (CAMHS) were “failing the next generation. We risk our CAMHS becoming a source of national shame if they continue to be so poorly resourced.”....read more
Average waiting time for GP appointment increases 30% in a year (Pulse: 10 June 2016)
The average waiting time for a routine GP appointment has almost hit two weeks, a Pulse survey has revealed.
The survey, answered by 831 respondents, found that the average waiting time for an appointment was just under 13 days – an increase from 10 days last year.
The respondents said that they expect the average time to be around 17 days next year. GP leaders said that this proves that the crisis in general practice is having a real effect on patients.
It comes as practices are having to stop providing appointments in advance – only accepting emergency appointments – due to workload pressures. Around 41% of GPs who answered the question said that the wait was longer than two weeks, with 15% saying it was longer than three weeks.
The situation has deteriorated since last year, when the average wait for an appointment was 10 days, and only 26% of GPs said the wait was longer than two weeks....read more
Four practices set to close leaving 10,000 patients displaced (Pulse: 7 June 2016)
Four practices in Brighton and Hove which together service over 10,000 patients are to close after having funding pulled through the review of PMS contracts.
Pulse reported in January that The Practice Group handed back its contract for the five practices after PMS funding was cut by 20%. Although the provider agreed to continue providing services past its contract in March, NHS England has now announced that the practices will close.
According to a letter sent to stakeholders from NHS England, patients at three of the practices will be automatically transferred to other GP practices when theirs closes in July, September and November. The includes 4,000 patients of The Practice Whitehawk Road who will be able to attend a GP practice run from the same building. However, the 2,000 patients at The Practice North Street will have to register for a new GP themselves after the practice closes in July. The fifth practice currently run by the Practice Group is for homeless people, and NHS England is re-procuring this service....read more
GP practice forced to stop patients booking appointments in advance (Pulse: 6 June 2016)
A GP practice in Carlisle has stopped allowing patients to book appointments in advance because of the immense pressure it is facing.
Fusehill Medical Practice has introduced a telephone triage system, with a doctor speaking to all patients before they can book an appointment, and appointments only available on the day.
Partners at the practice have said that they have had trouble with the pre-bookable appointment system, and recruitment problems are worsening the situation.
It is the latest practice to do so, following a similar measure being taken by a practice in Swindon....read more
Practice 'loses £55,000' as CCG cuts £1m enhanced service without warning (Pulse: 1 June 2016)
A CCG has cut more than £1m in practice funding after decommissioning an enhanced service designed to improve care for vulnerable patients, without consulting the LMC.
Walsall LMC said that practices had employed staff as a result of the enhanced service run by NHS Walsall CCG, which involved elderly patients receiving extra health checks, care plans and medication reviews and had 100% sign up from local practices.
But the CCG has pulled the £1.13m funding - which was worth £55,000 for one practice - leaving practices having to make staff redundant.
The CCG said that this was because the scheme was 'not able to demonstrate value for money'.
However, the LMC said that it was primarily decommissioned because the CCG has a £20m budget gap.
The enhanced service was initially funded via the £5 per patient that CCGs were supposed to redirect from hospital budgets to support GP practices in reducing avoidable hospital admissions, as part of the Avoiding Unplanned Admissions DES....read more
The word compassion in all Latin derived languages combines the prefix, with (com) and the root, to bear or suffering (passio). For a doctor and all health professionals this is a given prerequisite. We suffer with our patients. It is the essential penance we shoulder in return for the wondrous joy of helping those in need.
I am a GP, and as such I act as one of the gatekeepers to the health service. People of any age and problem can walk through our door. Wherever possible we either treat or reassure. If not then we direct the patient to another NHS service for help.
In general practice we see a large number of patients in need. Few people more so than those struggling with mental health problems. There are 10 times more people suffering with major depression compared to 1945. It is utterly heartbreaking to see a depressed person who is struggling, only to reply to them: “Sorry, but the counselling you need is at least a six-week wait”. To this patient, six weeks is 42 days (and nights), 1,008 hours, 60,480 minutes or 3.63 million seconds.
These seconds are not ordinary seconds. Life feels like constantly walking in oversized wellies through knee-high wet mud. It is backbreaking, emotionally draining, gloomy and painful. As their GP, I have to condemn my patient to at least 3.63 million seconds of further torture without hope. I feel so helpless and cruel....read more
Penalties for under-resourced doctor concerns (BMA News: 16 May 2016)
GP practices rated outstanding or good by the CQC (Care Quality Commission) have benefited from more funding than those deemed inadequate or requiring improvement, the BMA can reveal.
A report released today highlights the pattern between practices with higher average funding per patient and better inspection ratings — raising concerns that under-resourced doctors are being penalised.
The report calls for fairer funding across the country and appeals to the Government and NHS England to ensure all practices are given at least the same funding as the average practice rated outstanding.
‘This analysis shows there is a clear link between the amount of funding a GP practice receives and the rating it is allocated by the CQC,’ BMA GPs committee chair Chaand Nagpaul says.
‘Despite this, the CQC takes no account of resources available to a GP practice when it grades its care, even if this leads to GPs and their staff being publically shamed with an “inadequate” or “needs improvement” rating.’...read more
'Red risks' identified for 111 provider switch (HSJ: 11 May 2016)
NHS 111 and GP out of hours services in east Kent are to be run by one organisation – but there are already fears about the transition to the new provider.
Primecare, which is owned by Allied Healthcare, will provide an integrated service from October, including a care navigator service to help more complex patients remain at home. The current providers are South East Coast Ambulance Service Foundation Trust for 111 and social enterprise IC24 for out of hours GP services.
The four east Kent CCGs say Primecare will initially run the combined service for three years, with an option to extend for another two. It said Primecare came top in a rigorous evaluation by patients and commissioners, who looked at safety, quality, service delivery and overall cost effectiveness.
However, a report to the CCG boards last month on the mobilisation of the new contract has five “red rated” risks including the risks related to this being Primecare’s first 111 contract, staff not transferring across from current operators and a new call centre not being ready in time. Even after planned mitigation, the risk around the new call centre remains at red....read more
Deep South: Kernow’s troubles continue (HSJ: 11 May 2016)
There are a number of organisations in the South West beset with difficulties, financial and otherwise. But Kernow Clinical Commissioning Group, along with Southern Health Foundation Trust, probably ranks among the most troubled.
The CCG’s problems first came to light in December when it revealed that it was not – as it had previously reported – forecasting half a million pound surplus, but a £14m deficit for 2015-16.
The shortfall ended up even worse than that – according to the latest information from the CCG, it finished with a £17.4m deficit (it actually overspent by £21.4m but was able to improve its position slightly because of a £4m surplus the previous year)....read more
16,000 patient practice on short-term contract as six APMS providers pull out (Pulse: 5 May 2016)
A 16,000 patient practice has been left on a short-term interim contract after six of the seven APMS providers invited by NHS England to tender for the contract pulled out saying it was unviable.
The partners at The Mandeville Practice in Aylesbury, Buckingham handed back their contract last year after being unable to replace a recently retired senior partner, and finding locum costs unsustainable.
Since April, the practice has been run by local APMS provider Practice U Surgeries Ltd, on an 18-month contract.
Former partner Dr Gill Beck says it has been left with ‘no security for its future’, adding that commissioners were now getting to grips with how the practice can be run long-term without destabilising adjacent practices.
Local GP leaders said the practice that was no longer viable under the traditional funding model and which would become a ‘poisoned chalice’ if recruitment problems continued.
Speaking on the current state of general practice at the BMA’s Special Representative Meeting (SRM) this week, Dr Beck told delegates: ‘Within 18 months of my retirement from that practice, my partners handed in their contract.
‘Seven private companies came round to look at this, to see if they would take it over. Six withdrew saying it was financially unviable. My practice has gone to a one-year contract with a private organisation with no security for its future.’..read more
More than 170 GP surgeries have closed in 3 years because of 'financial pressures' (The Mirror: 23 March 2016)
More than 170 GP surgeries have closed in three years with doctors citing the increasing financial pressures of running modern day practices .
The British Medical Association says it’s worried about further closures, as demand on GPs increases; while the Royal College of GPs says such closures can have a negative impact on patients.
An investigation by BBC Radio 5 live Daily found that 171 GP surgeries closed in England in the three years to October 2015. A Freedom of Information request revealed a third of these are due to contracts being terminated or not renewed - and another third due to mergers.
The numbers are echoed by the national data provider, the Health and Social Care Information Centre, which show the overall number of surgeries in England has fallen since 2010...read more
DH rescue package delayed as suggested £110m funding branded 'inadequate' (Pulse: 7 March 2016)
The health secretary’s promised ‘package of measures’ to ease the pressures on general practice has been delayed after wrangling over the size of the promised funding.
Pulse has learnt from insiders that the Department of Health has proposed a £110m rescue package of measures for GPs, including a refreshed retainers scheme and more than 100 ‘golden hellos’ to tempt GP trainees to work in hard-to-recruit areas.
The GPC refused to confirm the amount that has been discussed with DH officials, but told Pulse that they were pushing for a much larger investment to ease the pressures on general practice in England.
The wrangling comes after a disastrous 'new deal' for general practice last year that was widely criticised by GPs as a massive over-sell.
Jeremy Hunt said in January that he would announce the new package of support for general practice in January saying he wanted to do more to ‘support the profession’.
He promised that it would be discussed with the RCGP and the GPC and released in February, but it has been delayed until later this month or April...read more
One in ten GP practices 'at risk of closure', warns BMA (Pulse: 3 March 2016)
More than 800 GP practices in England are at risk of having to close due to being ’financially unsustainable’, a major BMA survey has shown.
The survey of 2,830 practices found that 294 practices (10%) regard themselves as financially unsustainable within the next year.
It also shows that almost half of practices in England (46%) say they have at least one GP planning to retire, or leave UK general practice, in the next 12 months;The GPC says it has conducted the survey to supply evidence of the ‘state of emergency’ general practice is in, and the results follow the Special LMC Conference in January, which called on the GPC to consider canvassing the profession on potential mass resignation in six months...read more
NHS spend on general practice falls to 7.2% from April, despite uplift (Pulse: 25 February 2016)
Health secretary Jeremy Hunt will fail to deliver this year on his promise to increase the proportion of funding going into general practice, despite the 3.2% funding uplift for practices, a Pulse analysis has revealed.
NHS England budget allocations have revealed that from April, general practice will receive only 7.23% of the NHS budget – down from this year’s share of 7.31%.
This is despite the health secretary promising to increase the proportion of funding received by general practice and both the GPC and RCGP pushing for the proportion of spending on primary care to increase to at least 11%...read more
One in three GPs predict closure by 2020 unless seven-day plans are scrapped (Pulse: 19 February 2016)
A third of GPs believe that their practice will stop providing services to patients by 2020, according to new research.
A survey of GPs, carried out by think-tank Ockham Healthcare, further found that 90% believe the introduction of seven-day routine access to general practice will only worsen the current crisis.
In a new paper, the think-tank said that an ‘urgent response’ was needed the situation and called on the Government to abandon its seven-day access plans and begin to listen to GPs.
Like Pulse’s long-running Stop Practice Closures campaign, it also called for additional funding to be released to GP practices...read more
Out-of-hours provider forced to rely on one GP for 850,000 patients overnight (Pulse: 18 February 2016)
An out-of-hours provider in Norfolk has admitted GP shortages have forced it to run services with only one GP for 850,000 patients on at least one overnight shift.
It comes as the CQC confirmed it was planning to carry out an inspection of the service – run by Integrated Care 24 (IC24) – at the request of former care minister and local MP Norman Lamb.
The problems have emerged as the local CCG stepped in to investigate complaints about the quality of the service provided during the month of January.
NHS Norwich CCG said it carried out an ‘unannounced visit’ to IC24 after reports of concerns, including that a ‘depleted GP workforce’ was impacting on the quality and clinical safety of the service and that ‘assessors were made aware of situations when only one or two GPs were available for Norfolk and Wisbech’...read more
NHS 111 investigated over claims ‘teenagers answered urgent calls’ and ‘exhausted medics pictured asleep on job’ (The Independent: 16 February 2016)
The NHS 111 service is being investigated in the South West following allegations that teenagers had been drafted in to take urgent calls and photographs emerged of “exhausted” medics asleep on duty.
A number of 17-year-olds were allegedly employed by the South West Ambulance Trust last year to meet call handling targets. They had been authorised to take patients’ names and details and to offer basic advice on locating chemists and health services, but ended up answering urgent calls..read more
GP contraceptive services cuts are 'impacting on patient care' (Pulse: 15 February 2016)
Public health experts have warned that cuts to GP-run contraceptive and sexual health services will lead to worse access and lower quality of care for patients.
The Faculty of Sexual and Reproductive Health (FSRH) said the loss of GP contracts, as exposed by Pulse last week, had ‘worrying implications’ for the provision of long-active reversible contraception (LARC) in particular.
In a statement the Faculty said it had been contacted by a number of concerned GPs since Pulse's article was published and that its 'members are saying these cuts are impacting directly on patient care’.
Pulse's investigation revealed that GPs are losing contracts to provide LARC services in both York and London, while in one area of Devon, GP practices are facing a cut in the number of LARC fittings GPs are funded to perform – meaning they will have to drop the service altogether...read more
One in five London practices could close, warn LMCs (Pulse: 15 February 2016)
Almost one million people in London could lose their GP in the next three years, an LMC survey of GP practices in the capital has shown.
Londonwide LMCs, which received responses from 644 of London’s 1,330 GP practices, found that one in five (20%) cannot rule out handing back their contracts.
Out of these, 19 practices - which together cover 116,491 patients - said they are planning closure within the next three years, while a further 20 practices said they were considering closing within three years.
The number of patients who face losing their GP rises to over 900,000 when those respondents who said they ‘could not rule it out’ were included, according to Londonwide LMCs calculations...read more
Leaked report reveals scale of crisis in England's mental health services (The Observer: 13 February 2016)
A leaked report by a government taskforce has painted a devastating picture of England’s mental health services, revealing that the number of people killing themselves is soaring, that three-quarters of those with psychiatric conditions are not being helped, and that sick children are being sent “almost anywhere in the country” for treatment.
Details of the damning assessment have come to light just as the prime minister is planning to herald a transformation of mental health services.
The report, due to be published on Monday to coincide with an announcement by the prime minister on funding and new initiatives, lays bare a system that is routinely failing people from every walk of life.
While the prime minister is expected to trumpet his focus on mental health – six years after he pledged to put mental wellbeing at the centre of his government – his own taskforce condemns years of underinvestment and lays a significant portion of the blame on the current administration...read more
100 GPs sign letter on Pulse telling Prime Minister general practice is 'not safe' (Pulse: 5 February 2016)
Over 100 GPs have co-signed a letter warning Prime Minister David Cameron that general practice is no longer safe for patients, and telling him to start treating NHS staff with more respect.
The letter from Tower Hamlets GP partner and LMC member Dr Naomi Beer, published on Pulse only last night, argues that the NHS is not safe in Mr Cameron’s hands and urges him to start listening to GPs to find a remedy to the situation.
Dr Beer, whose practice launched a campaign to stop closures resulting from MPIG cuts in 2014, said Mr Cameron must stop ‘misrepresenting evidence’ to ’suit his ideologies’, while treating NHS staff ‘with contempt’.
She says Mr Cameron ’appears blind and deaf’ to what is happening around him, with ’doctors and nurses who are burned out, shattered, sick and exiting’ and this is why GPs at the Special LMC Conference last week voted to ‘if it comes to it, tender mass resignation’...read more
Spike in mental health patient deaths shows NHS 'struggling to cope' (The Guardian: 26 January 2016)
A sudden spike in the number of mental health patients dying unexpectedly in NHS care has prompted calls for a wide-ranging investigation into “threadbare” services that are “struggling to cope”.
New NHS figures show that the number of deaths annually among mental health patients in England has risen 21% over the last three years from 1,412 to 1,713.
The number of those killing themselves or trying to do so has also increased, by 26% from 595 in 2012-13 to 751 in 2014-15. It covers both those being treated as inpatients for serious mental health problems and also those who are being cared for while still living at home.
Figures obtained by Norman Lamb, the Liberal Democrat MP, show that the overall number of “serious incidents” – involving unexpected or avoidable deaths, serious harm, injury and abuse – has climbed 34% to 8,139 a year. They have become so common that one trust, North East London foundation trust, had a total of 633 last year – almost two a day.
Lamb, the mental health minister in the coalition until last May, made the comparison with the Mid Staffordshire scandal in which patients died as a result of poor care....(read more)
Healthcare group to walk away from five Brighton and Hove surgeries putting care of 11,400 patients in doubt (The Argus: 16 January 2016)
The future care of 11,400 residents has been thrown into doubt after a health group announced it would stop running five GP surgeries.
The Practice Group has announced its intention to terminate its contract for five surgeries in Brighton and Hove following a dispute over funding.
Brighton Pavilion MP Caroline Lucas has urged healthcare bosses to think again and warned other city surgeries could not cope with additional patients if the surgeries did close.
Staff are said to be very worried by the development following around two weeks of rumours about the future of the surgeries. NHS bosses have moved to reassure patients that their immediate care is not at risk and that this would not be a repeat of the Goodwood Court closure last June which left 10,000 patients without a doctor.
The Practice Group has given notice that they will be pulling out of their contract at the end of June with Brighton and Hove Clinical Commissioning Group expected to take over its running after that if an alternative provider is not found...read more
NHS out-of-hours GP service 12-hour wait 'clinically unsafe' (BBC: 15 January 2016)
Callers to out-of-hours GP services faced waits of more than 12 hours, posing a "significant risk to patient safety", a leaked report has revealed.
The interim report into Integrated Care 24 (IC24), which runs non-emergency 111 and out-of-hours services in Norfolk and Wisbech, found deficiencies in call handling and a shortage of GPs. During unannounced inspections following complaints, staff said they had been asked to alter their records.
IC24 said it had addressed the issues.
The organisation operates NHS 111 services in areas including Great Yarmouth and Waveney and parts of Essex, and took over the Norfolk and Wisbech contract in September 2015.
Assessors from Norwich Clinical Commissioning Group (NCCG) inspected five IC24 bases in Norfolk and one in Cambridgeshire in November following staff complaints.
Their report highlighted issues including:
- An "emerging trend" of 111 callers waiting to be processed and an IT system that did not allow patients to be triaged effectively
- The call-handling system was "unclear for patients" with some "waiting in excess of 12 hours from their first contact which is clinically unsafe posing a significant risk to patient safety"
- Staff "asked to alter or not record accurately their contemporaneous notes"
- Staff said they had been unable to comply with requests, including "removing unseen patients from their screens in the morning and advised that a non-clinical member of staff had cleared the screen" of callers not dealt with
- "An element of fear" among staff over reporting concerns.
- A lack of GPs, having a "direct impact on the quality and clinical safety of the service" and on doctors themselves
- Staff concerns over "competency skills of individuals recruited to fill the GP shortfall"
- GPs unhappy at being consistently moved between bases to cover shortfalls
... read more
GPs forced to close practice lists (The BMA: 6 January 2016)
Increasing numbers of GP surgeries are being forced to turn away new patients owing to immense pressures.
BMA GPs committee chair Chaand Nagpaul has commented in response to an investigation by the BBC into the numbers of surgeries across England requesting a freeze on registering new patients.
The investigation, carried out under the Freedom of Information Act, shows that at least 100 surgeries applied to NHS England during 2014/15 for permission to stop accepting new patients.
Dr Nagpaul said that many surgeries were no longer able to cope with a lack of resources and intense demand, and were having to close their practice lists in order to safeguard patient safety...read more
New wave of practice closures could mean 25,000 patients lose their GP (Pulse: 6 January 2016)
Tens of thousands of patients could be forced to register with another GP, as several practices prepare to close their doors early in 2016.
Pulse has learnt that six practices in England and Wales are closing due to GPs retiring early or becoming ill, leaving over 25,000 patients facing the prospect of moving practices.
GP leaders say the figures are a ‘terrible concern’ for patient access to primary healthcare and are the result of years of underfunding. This latest wave of closures comes months after Pulse revealed last year that 160,000 patients were displaced across the country between 2013 and 2015.
Pulse launched a ‘Stop Practice Closures’ compaign in 2014 to highlight the numbers of practices at risk of going under, but only recently have managers recognised there is a problem...read more
GP practices allocated 4% funding boost every year until 2021 (Pulse: 17 December 2015)
The Government will give general practice a funding boost of at least 4% every year over the next five years to cover the ‘changes in GP workload’, and will update the formula used to allocate funding to individual practices, NHS England has announced.
In a statement today, NHS England said that the the budget for general practice will increase by 4.2% next year, to £7.65bn.
The funding increases for general practice will be ‘disproportionately higher’ than for other services.
It has also announced that it is updating the formula used to allocate funding to practices, because of changes to the GP workload since the current Carr Hill formula was developed a decade ago...read more
Lowestoft will not get any new GP surgeries to replace two which have closed (Lowestoft Journal: 12 November 2015)
New GP surgeries to replace two closed in Lowestoft by a health watchdog have been ruled out if the practices are shut permanently. HealthEast – the clinical commissioning group (CCG) for Great Yarmouth and Waveney, which is responsible for healthcare services in the area – released an online questionnaire giving the 5,000 patients affected at the Marine Parade Surgery and Oulton Medical Centre three options for the long-term resolution to the closure.
But it ruled two of those options out, saying that negotiating a service for patients with new and existing providers would take between nine months and a year – even though the chairman of Oulton Medical Centre patient participation group (PPG) said retaining services at that site would be their preferred option.
The CCG also ruled out sending a letter to all patients at the two surgeries telling them to register with another GP, saying: “It would mean GP practices could not plan the services effectively as they would not know how many patients wanted to register.”
That means the only option left is for the CCG to work with the neighbouring Bridge Road and Victoria Road surgeries – which are
currently offering temporary care
to patients affected by the closures
– to see whether they would have
capacity to look after them long term.
HealthEast aims to make a decision by December and implement it afterwards – but it is still unclear whether the two surgeries will remain permanently closed, should the owners overturn the decision in an appeal...read more
NHS 111 scandal: 25 deaths blamed on ambulance delays (The Telegraph: 30 October 2015)
The Telegraph published an exclusive report on an investigation of 25 patient deaths following a whistleblower's revelation that a policy of 111 managers resulted in delayed help for seriously ill patients.
Senior managers at South East Coast Ambulance trust were warned repeatedly that their “rogue operation” was risking lives, yet the secret policy was allowed to continue, the Telegraph's source said. Documents seen by The Telegraph show how the consequences of the unauthorised policy of deliberately delaying ambulances to thousands of patients suffering from potentially fatal conditions were covered up.
Under NHS rules, calls designated as “life-threatening” are supposed to receive an ambulance response within eight minutes regardless of whether the caller dials 999 or the non-emergency 111 line. But the ambulance trust, which covers Sussex, Kent, Surrey and North East Hampshire, “unilaterally” invented its own system resulting in the routine downgrading of 111 calls, giving paramedics an extra 10 minutes to attend.
Under the secret protocols, for more than two months, thousands of 111 callers were forced to wait up to twice as long, effectively punishing patients for calling the non-emergency number.
Health watchdogs are investigating the trust to uncover how many patients may have been harmed by the delays between last December and February.
This newspaper has established that an NHS investigation was told of 25 deaths of patients whose ambulance response was believed to have been delayed under the policy. Since then there has been a dispute about how many deaths occurred among patients who were treated under the policy.
They include the case of a Sussex man aged 60, whose call was downgraded in January despite the fact he suffered clear signs of a cardiac arrest while on the phone to 111 call handlers. The man, from Horsham, died soon after paramedics finally arrived, 39 minutes after the call was made.
The trust said its own investigation did not find that the protocol had a negative impact on patients.
The Telegraph found that 111 call-handlers had no idea that when they ordered an ambulance to be dispatched for “life-threatening” conditions, calls were being delayed by up to 10 minutes. Documents reveal that as concern grew among senior NHS managers, official reports were doctored in an attempt to ensure the unauthorised policies remained secret.
The trust has refused to say who introduced the policy and whether any managers have been disciplined.
A trust senior manager, who spoke on condition of anonymity, said he warned the trust’s chief executive, Paul Sutton, in January that the policy – which aimed to relieve pressures by reducing the number of ambulances sent out – was too risky.
In early February, Mr Sutton and other senior managers were sent a series of emails from senior staff outlining concerns. But it was not until the NHS manager anonymously contacted health officials at nearby commissioning groups warning them of several deaths that the trust was ordered to abandon the policy.
The manager said: “They were warned again and again about the risks this was posing to patients.”
A trust spokesman said: “We will now work closely with Monitor as they undertake the reviews outlined in their recent media announcement and therefore do not feel that it is appropriate to comment further on specific points at present.”
The spokesman queried the suggestion that 25 people had died as a result of the policy. He said: “Our investigation and our own internal processes to date have not found that the process impacted negatively on patients.”
South East Coast Ambulance 'failure' over NHS 111 calls (BBC England: 30 October 2015)
An NHS ambulance trust is being investigated after it dodged national response targets to gain more time to assess some seriously ill patients.
In a pilot project, South East Coast Ambulance delayed sending help for certain 111 calls and transferred them to the 999 system, thus gaining an additional 10 minutes to respond.
Health regulator Monitor said it had not fully considered patient safety.
The trust has defended the project but acknowledged the "serious findings".
South East Coast Ambulance Service NHS Foundation Trust (Seacamb) covers Kent, Surrey, Sussex, Brighton and North East Hampshire.
As part of the pilot from December 2014 to February, the trust transferred some calls between systems to re-assess what type of advice or treatment patients needed and whether an ambulance was really required...read more
NHS at risk from “explosion” in number of ageing patients with multiple illnesses (The Mirror: 1 October 2015)
Rubbishing David Cameron’s plan for a seven-day health service, Britain’s top GP says primary care funding has fallen to dangerous levels.
The NHS faces an “explosion” of one million extra patients living with multiple life-threatening conditions, warns Britain’s top GP.
Maureen Baker, chair of the Royal College of GPs, says the health service is already “struggling” with an estimated six million over-60s who have several complaints such as cancer, diabetes and heart disease.
She predicts there will be another million by 2025 and accused the Government of allowing funding of primary care to fall to “dangerous” levels.
The RCGP says 90% of all patient contact with the NHS is in general practice but it gets just 8.33% of the budget.
Dr Baker wants chancellor George Osborne to ensure primary care gets 11% of the overall NHS budget, 10,000 more GPs and “an immediate injection of £750 million of additional core funding in the next financial year”.
Describing the growing number of people with more than one serious illness, Dr Baker says: “They might be living into their 70s, 80s, and beyond, and would almost certainly be coping with one, two, three or more long-term conditions.
“It is a great testament to modern medicine that nowadays we are much more likely to prevent or treat diseases that in the past killed people so early in their lives.
“But this success has brought with it a whole new set of challenges to which the NHS is currently struggling to respond.”
David Cameron has pledged seven-day GP services by 2020. But Dr Baker says he is “living in cloud cuckoo land” and his plans were a “recipe for disaster” given the lack of investment in GPs.
She warns: “If you don’t shore up existing GP care, not only will you not get a seven-day service, but you won’t have a five-day service either.”
Two-thirds of GPs say long waits ‘biggest barrier’ to treatments for mental illness (Pulse: 23 September 2015)
Two-thirds of GPs say long waiting times for psychological therapy are preventing patients getting treatment for common mental health problems, a survey has revealed.
The findings suggest GPs are struggling to offer the most appropriate therapy because of lack of access to services – in stark contrast to recent claims by Prime Minister David Cameron that GPs were failing to treat patients or offer them ‘increasingly available’ cognitive behavioural therapy.
The survey of 1,000 GPs in England showed that 66% see waiting times for psychological therapy as the ‘biggest barrier to treatment’.
The research – commissioned by a provider of online mental health therapy services for the NHS – also included focus group discussions, in which GPs reported that longer waiting times for talking therapies would make them more inclined to prescribe antidepressants as a stop-gap. The report also highlighted that 37% of patients referred for Improving Access to Psychological Therapies (IAPT) services did not enter treatment in 2013/14, while 11% – around 76,000 – waited 90 days or longer to be seen.
Overloaded London GPs cannot cope, warns report (The Guardian: 12 September 2015)
GP surgeries in London are at “saturation point” and cannot provide any more care to patients, family doctors’ leaders in the capital have warned in a dossier of evidence sent to MPs. Representatives of 7,000 GPs at 1,300 practices claim they cannot cope with existing demand and that the situation will get worse as London’s population soars to 9.2 million by 2020. Cuts to health visiting, community nursing, mental health and other services have turned surgeries into places where patients with nowhere else to go turn up but experience “a revolving door of consultations”, they say.
This stark depiction of overloaded practices is contained in a submission to the House of Commons health select committee’s new inquiry into the growing pressures on family doctors and primary care. It has been made by Londonwide Local Medical Committees, an umbrella group for the statutory bodies that represent GPs in 27 of the 32 boroughs.
Despite GPs’ efforts to meet rising demand for appointments, “the reality is that the saturation point has been hit even by the most competently working practices in London. General practice in London is beset by blockages in flow, diverting staff from consulting, co-ordinating or planning care, and both reducing access to patients and demotivating professionals,” the submission said. Family doctors are “stressed and depressed” trying to maintain the quality of care they provide in the face of “unprecedented rises in patient demand”, caused by an ageing and growing, and increasingly unwell population.
“It’s reckless and shortsighted to stop providing support services in the community such as health visitors, mental health services and social services because they get overwhelmed and telltale signs of illness get missed,” said Dr Michelle Drage, chief executive of Londonwide LMCs. “That leads to GPs having more consultations, less time with patients, and patients waiting longer for appointments. Everybody gets a worse deal.Too many GPs and practice nurses in London are running on empty trying to manage these rises in demand.”
GP surgery in Gloucestershire closes after 67 years due to no doctors to run it (Gloucester Citizen: 29 July 2015)
Private NHS contractor 'boots out patients before finishing treatment to meet targets' (Mirror: 21 July 2015)
Jeremy Hunt denies coalition created shortage of GPs (The Guardian: 19 June 2015)
Thousands of patients forced to hunt for a new GP as staffing shortages accelerate practice closures (The Independent: 1 June 2015)
Private APMS provider has three practices put in special measures by CQC (Pulse: 7 May 2015)
Private providers of out-of-hours GP services deliver poorer care than NHS, research finds (The Independent: 30 April 2015)