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Gold, incentives and meh

GP practice numbers could be cut by up to two-thirds under CCG draft plan

A CCG has included a cut of GP practice numbers by up to two-thirds in its draft primary care strategy, based on a 'national trend' towards larger practices.

NHS Southampton City CCG, which currently has 32 GP practices, has published a draft strategy on its website proposing this would become as few as 10.

The document said that the strategy, for which there was no timeframe, 'will deliver the principles of better care' by 'joining up services seamlessly around the patient'.

It comes as the city’s primary care services have already been divided into six clusters, each serving around 30-50,000 people and based upon existing groupings of GP practices and community nursing teams.

NHS Southampton City CCG said it has 'no plans' to 'enforce the closure or merger of any GP practices' and said that the paper was based on 'trends observed around the country'.

The consolidation proposals come as elsewhere in the country GP practices of an industrial scale are emerging, including the 275,000-patient Our Health Partnership across Birmingham and Sutton Coldfield and the 100,000-patient Lakeside Healthcare super-partnership in the East Midlands, both formed via massive mergers last year.

This year, there is also the proposed mega-merger of a 540,000-patient practice across Suffolk. Meanwhile, a year ago Pulse revealed a 500% rise in practices telling NHS managers they wish to merge or close.

Suggestions in the Primary Care Strategy for Southampton include:

  • 'The patient will have a choice of practices, we anticipate eventually between 10-20 practices across the city';
  • 'Care will be outcome-focused, with appropriate services being available seven days a week';
  • 'Practices in each cluster will work together with other services such as social care, housing, education, voluntary sector, community navigator, and the police (multi-disciplinary team)'.

NHS Southampton City CCG told Pulse that this was not the finalised primary care plan for Southampton, which would be published later this year, but confirmed it was 'working intensively with a number of GP practices in the city that are experiencing workload and staffing pressures'.

A spokesperson said that 'in certain cases this means that mergers or closures may be proposed by the practices themselves', but added that patients would be consulted before any such decisions were taken.

The spokesperson said: 'We are committed to ensuring that high quality, accessible GP services are available across Southampton and have no plans to reduce the number of GP practices in the city. Our draft strategy for primary care remains a work in progress at this stage.'

The Southern Daily Echo newspaper, which first reported on the plan, warned it would lead to closing of surgeries and reduced access and continuity of care for patients – suggestions the CCG strongly rejected.

It quoted an anonymous primary care worker who said 'changes would put the welfare of thousands of patients in jeopardy and would lead to a further crisis for the GP service'.

But Wessex LMC leader Dr Nigel Watson said that Southampton general practice was currently 'running at 10% vacancy rates' with 'a number of practices imploding'.

He said: 'The CCG can’t make any of the practices merge under their current contracts but they can provide incentives, and if it does happen it might work to patients’ benefit... We’ve not had this discussed with us directly but it’s based on a lot of things we have already talked about with the CCG.’

Consolidation of GP practices

Although not all practice mergers lead to the behemoth size of Our Health Partnership or Lakeside Healthcare, the Government has mandated NHS England to ensure that 50% of patients are registered with at-scale new models of care by 2020.

The new voluntary GP contract, for practices with at least 30,000 patients, will underpin this when it is rolled out from next April.

The move towards consolidation is further underlined in NHS England's GP Forward View, which ties many funding streams to at-scale operating models.

And NHS England has already incentivised its pilot projects with £37m for 2016/17 to work up larger GP practice models that can be replicated elsewhere. 




Readers' comments (22)

  • Great idea but not possible unless the government is happy to pay the same rate for every patient. Would be a serious blow to privileged Practices but a lifeline for underfunded ones. Bring it on.
    It's just another experiment but for those at rock bottom there's really nothing to lose.

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  • Yes the near death of personalised care . RCGP can forget rapport and psychosocial stuff .it will be dr no name seeing a cough
    Cost a lot more and increase referrals

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  • Poor patients.this ccg doesnt care just make sure the managers at the top are getting paid.who really cares.this is all political gimmick

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  • our CCG is well ahead of this plan

    in Clacton it looks like the practices may decrease by 3 thirds

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  • 11:59- In Medway plans initial talks are taking place and hubs formed of around 30-36 thousand patients except for one hub of two opposite poles of Medway for unknown reason of almost 74000 population. It seems somebody out there is just trying to get more mileage by placing a hub centre 8 miles from their Surgery. No pun intended.
    By the way can you class Practices with 8-12 thousand patients as rural anymore and deprive a Practice of Rularity factor built on distance from Surgery if 25% population lives beyond 3 mile? This Rurality has become a joke with Practices having 12000 patients in the city in new posh localities being named Village Surgeries and being aid rent reimbursement to the tune of 180000 per year with above average payments per patient.
    Those who know the system will continue to milk it and the government can't be bothered.

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  • Vinci Ho

    Damned you do ; damned you don't.
    It is about survival . Perhaps there should be some 'impact assessment' from CCG with this move.
    But nobody will be naive to believe one plus one is two in terms of funding . The true face of this government is well exposed . EU referendum , to a good extent, has become a protest vote for austerity on internal business.

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  • Did they really say care will be "outcome focused".
    Not "patient focused"?
    This is Awful

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  • SMALL PRACTICES have premises to sort out before they close or join. ccg is not offering seamless but shameless serivice where patient will be just a number. DOCTOR WILL CALL PATIENT 1059 TO ROOM 24.
    till today i come out to receive patients and observe a lot before they sit dowm. it is economy that attract ccg to do this merger.

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