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Independents' Day

Four practices to close in Plymouth for not fitting with 'national blueprint'

NHS England has decided to close four GP practices in Plymouth because their ‘relatively small size’ is not a fit with the 'national blueprint' for 'the direction of travel'.

NHS England (South West) said it was 'moving ahead with a series of changes to the way GP care is organised in Plymouth' which will see the GP practices at St Barnabas, Hyde Park, Cumberland and Saltash Road - which between them have just over 17,500 patients on their lists - close at the end of March.

Among reasons behind the decision, NHS England listed 'the direction of travel set out in the national blueprint, the General Practice Forward View, which recognises the pressures and points towards a future in which surgeries operate "at scale" rather than as separate, small businesses'.

The news comes despite NHS England rejecting claims last month that it is allowing to fail. As revealed by Pulse, a senior NHS England official said vulnerable practices must ‘transform…or be allowed to fail and wither’, but a press office spokesperson said the comments did 'not reflect national policy whatsoever’.

A total of seven Plymouth GP practices were at risk of closure, after previous providers handed back their contracts, but NHS England has decided to tender for new providers for the practices at Ernesettle, Mount Gould and Trelawny, and a new practice at Barne Barton.

Access Health Care, a subsidiary of Devon Doctors, is temporarily running all existing seven practices until the contract runs out in March. NHS England is planning for the remaining three practices, and the new practice, to have new contractors from 1 April.

In a statement, NHS England emphasised that the closure decision was taken separately for each practice, but they had some common factors including ‘the relatively-small size of the practices’, which 'makes them unattractive to would-be providers who would take on the financial risk of running the business at a value of £76.44 per patient per year’.

NHS England also said that the size makes recruitment a difficulty, as 'young doctors prefer to be salaried or to work as locums, working within larger practices, which makes it particularly hard for small practices to recruit'.

The statement said: 'In the case of all seven existing surgeries, the previous provider had stepped away because they could not sustain the service. A temporary provider was appointed to provide breathing space, while the longer-term future was considered.’

They decided there was ‘no realistic prospect’ of getting a new provider for the closing surgeries ‘in the face of rising workload and financial pressures’. They also said that most of the patients would be able to move to one of 20 practices within a two-mile radius.

Amanda Fisk, director of assurance and delivery for NHS England in the South West, said they had considered 'every single comment' made in a public consultation about the future of the GP practices, which had showed 'very clearly how much people value their local surgery'.

But she added that 'unfortunately, when weighing up all the factors, the reality of rising pressure on general practice led us to conclude that we would be unable to find anyone who was both willing and able to keep these surgeries open'.

Dr Stephen Warren, a GP at Hyde Park Surgery, told the Plymouth Herald: ‘I think it's unwise to close four GP surgeries at once...I did my best to warn NHS England, but my warnings haven't been heeded.’

‘We were a five-star surgery and yet the current recruitment issues mean long-term sustainability was in question.'

Are small GP practices being run to the ground?

Comments made last month, in a briefing sent out by Paul Twomey, medical director of the Yorkshire and Humber area team, had indicated that NHS England would a allow GP practices to fail if they did not 'transform appropriately' in line with Forward View plans.

He said that NHS England is ‘no longer in a position’ to continue supporting vulnerable practices, but NHS England said letting practices fail was not national policy.

The statement from NHS England's South West regional team refers to the GP Forward View, the general practice rescue package published by NHS England in April.

This said that 'larger organisational forms will enable greater opportunities' for GP practices and have them working from 'a more effective platform', integrating with other health and social care providers.

It also promised an extra £40m ‘resilience’ fund for vulnerable practice, with £16m available this year, but despite this practices are continuing to close.


Readers' comments (18)

  • Collectivization in action!

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  • Just shows that the National blueprint is an oxymoron run by morons remove all forms of private company from being anywhere near NHS facilities before destroying practices.
    Addressed to ignorant self centred money grubbing administration of the NHS, who in any other world would be jailed for not being fit for purpose

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  • Ref: Anonymous GP Partner @ 10:21
    I absolutely agree - no more private developers colluding with GPs (who are self employed contractors, don't forget) to build big shiny new practices which they then tout out to local pharmacies at extortionate rents and "premiums" (that's a bribe to the rest of us) and hold them over a barrel on threat of destroying their(here comes the naughty word) business, all so GPs can have a nice fat pension to sit back and laugh at the rest of us. Hearts bleeding? Not here!

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  • oh, so there IS a blueprint is there? Care to share, PHE, or is it political dynamite?

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  • Even working at scale they need to be funded appropriately for the work expected.
    No-one has asked patients what they want from their primary care. If they did it would not be what is being proposed. The business model is no longer fit for purpose and is unattractive to any sane doctor. The move is towards a fully salaried system so that everyone is employed and controllable. It won't be by NHS bodies either as the move is away from the state to a private denationalised system. It will still be "free" at the point of delivery but very much more restricted by virtue of limited supply.

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  • Campaign for the Labour Party that is sympathetic to the NHS. Another term for the Tories will see it annihilated .

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  • 11:18 am..
    too late..labour is unelectable.

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  • Hey Pharmacist...perhaps you want to mention how Pharmacists are fleecing the NHS?

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  • The crucial information in this piece is the underfunding. Allowing only £76.44 per patient per year is less than the cost of insuring a pet rabbit (£84.60 including a 10% online discount).
    The politicians need to be held to account in promising a five star service on one star funding. Patients should be told their value to NHS England, after all they are told the earnings of GPs.

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  • Atul Kothare | GP Partner10 Nov 2016 2:29pm

    I'm sure you're dying to enlighten us

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