Let struggling GP surgeries fail, says NHS England letter
Surely this approach cant be right – particularly in relation to those struggling practices where sparsity is a contributing factor. This story tells us:
Some struggling GP surgeries in England will be allowed to fail and close, according to a leaked document seen by the BBC.
A letter from an NHS England official to managers and GPs in one region suggests vulnerable practices could be left to “wither by the system”.
The note claims NHS England is no longer able to “continue supporting practices irrespective of their ability… to transform appropriately”.
NHS England denied this was the case.
A spokesman for the British Medical Association said it was “unacceptable” that some NHS managers believed that some GP practices would be left to close.
Vulnerable GP surgeries
A practice may be vulnerable due to:
a reduction in resources
rising workload
recruitment problems
understaffing
These are often practices rated by regulators as “inadequate” or “requiring improvement”.
It comes as media reports suggest much of a special fund to help struggling GP surgeries has not yet been handed out more than a year after it was unveiled. In June 2015, Health Secretary Jeremy Hunt announced a £10m investment in GP practices in England which were deemed to be vulnerable. This was formally launched by NHS England later in the year.
But last week, the medical publication Pulse reported that barely any of the fund had reached GPs. Managers administering the fund in each area were said to be still identifying which vulnerable practices would qualify for the support.
NHS England did not deny the report, though a source said the organisation was “working through its local teams to ensure the funding available through the vulnerable practice programme is fully committed to named individual practices by the end of October”.
Around 800 out of a total of 8,000 practices are deemed by NHS England to be in the vulnerable category. The criteria include a high number of patients per GP and an “inadequate” or “requires improvement” rating by the regulator, the CQC.
NHS chiefs said the aim was to provide support for practices under pressure and to ensure patients had continued access to high quality care.
In April 2016, NHS England announced an extra £16m for this year for a so-called “practice resilience programme”, with another £24m in subsequent years.
This pool of money was also aimed at shoring up struggling practices and was part of the GP Practice Forward View unveiled by the head of NHS England Simon Stevens.
But a letter sent by Paul Twomey, medical director of the NHS England North Yorkshire and Humber area team, to local GPs and health officials in August suggests a harder line stance.
Transform or wither
In it he says: “The message we need to communicate to general practice is the GP Practice Forward View must be about transformation and in that sense is not like a pilot.”
He goes on to express his belief that local health leaders will understand that “vulnerable practices must either transform and deliver a quality service or be allowed to fail and wither by the system. We are no longer in a position to continue supporting practices irrespective of their willingness or ability as a provider to transform appropriately.”