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Independents' Day

NHS managers to ‘index’ GP practices most at risk of closure

Exclusive GP practices in the east of England will be identified by an ‘early warning’ system if they are at the risk of having to close, Pulse can reveal.

NHS England is working with the LMCs in the region on proposals which would see the launch of an ‘index of vulnerability’.

The index is intended to flag practices ‘where a number of issues impacting at the same time may make them vulnerable’, including indicators such as finances, recruitment issues, sickness absences and applications for list closures.

NHS England’s east area team said it will not publicise distressed practices and that it is continuing to discuss what support can be given once vulnerability is identified.

A spokesperson told Pulse that it is hoping to ‘support improved patient experience and continuity of care, by proactive identification and management of issues which many GP practices are currently experiencing’, but stressed that it was not intended as ‘a performance management tool’.

They added: ‘NHS England is working with LMCs in the east on the proposal, which would provide an “early warning” system to identify those practices where a number of issues impacting at the same time may make them vulnerable.’

Dr Guy Watkins, chief executive of Cambridgeshire LMC, said the move was in the interest of both patients and GPs. He said the LMC had pushed for a support model for practices when stability is threatened ‘before a crisis event rather than only afterwards’.

However he added the ‘most important’ part would be what sort of support NHS England will offer practices.

He said: ‘Cambridgeshire LMC has been working with NHS England for some time to try and agree some support for practices to help review their options when practice stability is threatened, often for workload or financial reasons, before a crisis event, rather than only afterwards.

‘NHS England have proposed an “index of vulnerability” to help them predict problems [but] perhaps more important is our seeking clarity over what NHSE proposes to do in these situations to support practices.’

However GPC chair Dr Chaand Nagpaul said that it would be more useful to have a nationwide approach.

He said: ‘We need a proactive, national, consistent approach rather than one that is occurring piecemeal in some areas. There is no consistency here.

‘We need to remove the burdens on practices, many of which are quite inappropriate.’

It comes as Pulse revealed last month that NHS England has launched a practice support scheme in the south whereby neighbouring practices will be drafted in to provide emergency support to colleagues struggling to keep surgeries afloat.

The initiatives follows camaigning by Pulse for NHS England to offer help to practices at risk of closure amid a hike in practices threatened by financial and workload pressures.

Readers' comments (11)

  • seems sensible risk strategy.

    what we need urgently is a new quango set up to monitor and issue feedback preferably in a traffic light system. marry that up with a new online system so that the public can search for their practice to see if it's in danger. The last thing we need is for funding to go to those at risk practices.

    my best guess is that there are 8000 surgeries at risk of closure.

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  • PS if you need a GP to sit behind a desk to monitor the situation rather than seeing patients in the front-line - i'm up for it. I've already practiced my serious and concerned look and am learning political speech eg ' this is a serious situation and more needs to be done. we owe to the hard-working public who are also patients and need to have access to GP surgeries. This is a situation that we take seriously ...' etc etc

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  • 'NHS managers to (fiddle) ‘index’ (whilst) GP practices (Rome) most at risk of (burns) closure.'

    Please could NHS managers grow a pair and lobby, scream, shout or even write a well intentioned email to Hunt and his DfH to tell him they cannot manage without the funds to do so.

    NHS managers to (shuffle)‘index’ (deckchairs) GP practices (Titanic) most at risk of (sinks) closure

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  • I wouldn't trust my local area team as far as I could spit.

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  • Yes, a bit like doing the 2% risk strat meetings. Will practices get a printed copy of their care plan? Sounds like this will save General Practice! Excellent!《shuffles off to take olanzapine》

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  • Vinci Ho

    Ministry of Plenty, has it really got 'plenty' capacity to help ? Don't forget the Chancellor wants to cut more spending in government departments.
    An index is a label . Is there a real advantage for a struggling practice to be 'labelled'? Don't forget issues like recruitment and sickness problems are linked to morale overall. It is natural people want to stay away from practice labelled as having 'troubles'. Hence the label can backfire.
    Obviously , on the balance,one should still be open mind about this . More interested in the details of how individual practice will be helped successfully at the end......

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  • If you ask Cameron or Hunt, they will say "there has never been a better time to be a GP, the RCGP chairwoman told us so, so it must be right" "we are giving patients access to (non existent) gps 7 days a week 365 days a year". Ostrich with head in the sand syndrome, and when it all implodes, no accountability. No one is doing anything except talking, and by time the crisis implodes the NHS, they will all be gone. The losers...the patients.

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  • 'Drafted in to support'
    1) like anyone has spare capacity
    2) contractually other practices' patients are NHSE's problem not ours - let them sort it; they malcommissioned the service

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  • If you were "on the little list" would you feel relieved as will get help if struggling or would you feel you had to keep quiet about any issues in case they shut you down by the next morning ?

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  • We are like fishes in a lake during a drought. NHSE hope to save the fish by throwing buckets of water over the few minnows stranded as the waters recede, yet cannot comprehend the numbers of dying fish under the water.

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