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At the heart of general practice since 1960

Managers in crisis talks as GP practices across whole town close their lists

Exclusive GP practices across an entire town have stopped registering new patients because of recruitment problems, leaving the CCG to call an urgent meeting with the last practice to close its list.

GP lists at two of the three surgeries in Hessle, Humberside, are formally closed with NHS England’s approval until January and March 2017.

Pulse understands that the third and final practice, Park View Surgery, is also now not registering new patients.

NHS East Riding of Yorkshire CCG said it had called an urgent meeting with the practice team this week to discuss their situation.

The Park View Surgery confirmed to Pulse it was no longer registering new patients but its management team was not available for comment on the planned CCG meeting.

Dr Margaret Lovett, a GP partner at one of the other two practices in Hessle, the Peeler House Surgery, said it closed its patient list in March.

According to Dr Lovett, the town has had an influx of people moving into the area due to new housing developments but that GP practices cannot recruit GPs and staff to meet the new demand.

She said: 'We were getting 30 or 40 new patients a week, [but] you can’t keep accepting people – you can manage a certain list size. NHS England points out you get more money for those patients, but it’s no good having the money if you can’t recruit anybody.'

The practice recently moved to larger premises because its former surgery had just one consulting room, and immediately saw its list size jump more than 20% – with patients leaving other practices due to access issues.

Dr Lovett said: 'Because of difficulties at the other practices, we were also getting quite a few patients from the other practices who were saying they wanted to leave because of the difficulties getting appointments.'

NHS East Riding of Yorkshire CCG, which co-commissions general practice with NHS England, said Hessle was not the only town in the area where practices are struggling to meet patient demand.

Chief officer Jane Hawkward said that out of the 36 GP practices in the CCG area, there are 'a number who are currently not accepting new patients'.

She said: 'In partnership with NHS England we are working intensively with these practices to review and accelerate implementation of their action plans to get them out of their closed status.

'There are areas in East Riding of Yorkshire where we are struggling to recruit GPs and this reflects the national difficulty with recruitment and retention.’

She added that helping practices to become training practices was one of the measures the CCG has taken 'to assist with attracting GPs into the area and improve workforce capacity and capability'. To date she said this 'has been successful in one practice which has attracted both GPs, nursing and management staff too'.

Local GP leaders told Pulse that the situation in Hessle was causing NHS England managers ‘headaches’ as it means they are forced to try to allocate patients further away.

GPC representative for the area Dr Andrew Green said the situation was testament to the growing pressures on general practice, as it was ‘not traditionally part of the area which is hard to recruit to',

He told Pulse: 'GPs in East Riding, like everywhere, are struggling with workload. Many are looking at the workload they’ve got and deciding that for patient safety reasons they have to close their list.

'I actually think the ability to close your list is an essential part of the contract, it enables people to concentrate on giving care to the patients they’ve got.’

'If the more pleasant parts of our area are having difficulties then it’s a very bad sign for other areas.’

List closure fallouts

With NHS England’s pledged £56 million resilience fund seemingly a long way off, practices have few options for controlling their workload in the short term.

Pulse reported back in 2014 that list closure requests had surged by 160% amid pressures.

Pulse blogger Dr Hadrian Moss revealed last year that his practice had ‘informally’ closed their lists after it was highlighted in GPC guidance on managing workload pressures.

Though the process is contractually allowed, Pulse revealed that NHS England had threatened the practice with breach of contract when it first found out.

The dispute even reached Parliament with health ministers drawn into investigate before NHS England finally conceded that lists could be closed ‘unilaterally’ in urgent circumstances.

 

Readers' comments (50)

  • I am a GP working in Hull & East Riding working as Locum. I am willing to work as Locum or salaried or partner but pay rate is so RUBBISH, I have decided instead to work as Handyman, Gardener etc with cash in hand and earn more than GP.

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  • Please read above comment. What has happened to our profession?

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  • The first comment says it all really what a sh**fest primary care is at the moment.

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  • Now how is a super-practice going to solve this?

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  • I suspect the first comment just reflects the fact that some people are not cut out for general practice. General practice is a vocation (and a hard one at that). Concentrating on the £ (to the extent of tax evasion) probably indicates the wrong mind-set in the first place. The last time I did an appraisal there was this thing called probity.

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  • This is the future guys!!

    I would encourage the practices to not budge till proper investment is made.

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  • @|Anonymous | GP Partner|16 Jun 2016 10:52am

    Vocation is a word used to brainwash your generation into becoming efficient slaves. Probity you may know but what about critical reflection?

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  • @ 10.52 am Vocation can also mean that we can work day and night without respite and somebody will still find something to add on, maybe that one extra-well I think the managers already have a perfect person cut out for the job.

    The first statement states exactly where we are General Practice- handy men etc do not have appraisals, revalidation, CQC, GMC, CCG etc etc (kindly advise if anything new came up)

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  • From a PM perspective this is not an isolated problem its national. I hate to see our GP profession being worked into the ground hence ref first comment of a gardener watching things grow rather than destroying pardon the pun on words. Where is the education of patients using the NHS? Where is the support for looking at the expected work demand and making it a Clinical work process instead of paper trails audits etc which are helpful but not for every minute of every day. Work life balance where has that gone for the GPs?

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  • This happened in our town few years ago.
    One doctor who was left to go to Australia after going of sick with stress and then another doctor in the practice went of with a brain tumour.
    We shut our list, but other practices couldn't cope with the extra patients and shut their lists.
    Result? PCT put in a Darsi centre to give us "competition" to " up our game"
    Our practice serving some of the most deprived areas in the county with the lowest funding, the Darsi the highest.
    You couldn't make it up.

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