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Practices across entire town close lists as fears grow general practice will 'go under'

Exclusive There are fears that general practice in one English town could 'go under', with five practices having closed their list and a sixth practice set to close for good, potentially leaving 7,000 patients without a GP practice.

All six practices in the north Yorkshire coastal town of Bridlington have stopped registering patients, and they told Pulse their plans to ‘rebirth’ health care in the town are under threat.

Local GP leaders have warned the entire primary care system could ‘go under’ if NHS England can’t find a new provider to take on Field House Surgery when the current provider hands back its contract.

The remaining practices in the town - which has a population of around 35,000 and is struggling with the demands of an elderly population as well as a lack of GP workforce - are hoping to receive funding from NHS England for a £10.8million Health and Wellbeing Centre to house several of the practices.

One Medical Group took over Field House - which has a practice list of 7,000 -  two years ago and hoped to receive support funding from NHS England’s vulnerable practice fund but were unsuccessful in its bid.

It handed back its contract in October, and NHS England told Pulse no new provider was forthcoming after a ‘comprehensive’ procurement process, with a final decision to be made very soon.

Dr Mike Hardman, a GP and executive chair of the BridInc federation - which comprises five of the practices - told Pulse that the situation in Bridlington was a ‘perfect storm’ with patients leaving Field House increasing the pressure on the rest of the practices.

Dr Hardman said: ‘We’ve been trying to improve services, but we’ve got to the point where we can’t take on new patients and we’re all at absolute maximum, so all the practices are closed.

‘So in five weeks’ time, if NHS England can’t find a new provider, we might have this list forced upon us which will mean you’ve suddenly got 1,500 more patients when you’re not taking any, we don’t know how we’d do it.’

But Dr Hardman says the local practices, CCG, and NHS England have been given initial approval for the £10.8million Health and Wellbeing Centre, for which they are in the process of doing due diligence and refining the business case.

This would house several of the towns practices, and give space for out-patient clinics – a priority for Jeremy Hunt’s vision of ‘one-stop shop’ general practice - and social prescribing.

He told Pulse: ‘The idea is to provide Bridlington with a world leading facility; we’ve also got our first GP trainees for 20 years in Bridlington, starting in February. We’re starting to rebirth Bridlington, we hope, but we have this terrible, terrible destabilising force that threatens it all.’

Dr Zoe Norris, GPC salaried and sessional lead and a GP locum in the region, told Pulse if the patients were dispersed to practices already under pressure then ‘potentially the entire primary care system of this town will go under.’

She added: ‘I don’t know what the population of Brid is, but over the summer there are thousands as well, and many of these patients are frail, elderly with multi-morbidities greater than the national average.

‘I’ve always said Bridlington will be the first place where the whole town goes under.’

Heather Marsh, head of primary care co-commissioning at NHS England (North Yorkshire and the Humber) said: ‘The current service provider… contract is due to end on 31 December 2016.

‘NHS England has carried out a comprehensive procurement process to identify a new provider for the service. Unfortunately, we have received no bids from other companies to deliver services at the premises and ourselves and NHS East Riding of Yorkshire CCG are now working closely with local GP practices and providers to review all potential options.’

Jane Hawkard, chief officer, NHS East Riding of Yorkshire CCG said: ‘We have been working with NHS England to find a solution which best fits with the new integrated health and wellbeing model that ourselves, GP practices in Bridlington, our community services provider and social care want to deliver.

'The new integrated service model will ensure a sustainable future for health and care services in Bridlington.'

Earlier this month Pulse revealed that the loss of four partners from one practice in Portadown, Northern Ireland threatened to bring down the local primary care system.

Readers' comments (14)

  • The first dominoes have started to fall in England,which one will trigger the collapse?

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  • When there are no GPs left, CCG just needs to fund a noctor to prescribe 'bracing sea air' for all ailments

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  • Well done Jeremy.
    All going according to plan.
    Are you going to throw them a life ring?
    Or a brick?

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  • The DOH was asked to comment. They said "we are always thinking about patient care and how to improve it. In this parliament, there are now more GP's nurses, consultations and operations than ever before. We have invested 10b over this parliament, more than the labour government before us. We are growing an extra 5000 GP's in a local lab in a layer under Whitehall. There are many more noctors who can all do GP's jobs, especially these magic physcians associates that are all singing and all dancing. Don't worry at all. move along now. nothing to see here. Jeremy Hunt loves the NHS, he is not slowly destroying it and rubbing his hands in glee while laughing and stroking his cat."

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  • A flu epidemic this winter or next will finish us all. Not sure if a good or a bad thing.

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  • It is about time we GPs have a different system. I am angry, having had to deal with, due to a strange set of circumstances, accountants, lawyers and dentists. Their fees are staggeringly eye watering. They have no more A levels or qualifications.
    We are mugs to be a profession needing help, working the horrendous hours under enormous pressure to be bailed out and needing rescued.
    Shame on you, GPC. Look what is happening on your watch. It is your brief to look after your workforce.
    Giving radio interviews is not a solution, you know.
    I am so fed up with the way we are treated that the whole thing coming down like a house of cards weld be a fit and proper answer to Hunt's penance.

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  • NHSE rubbing hands and legs. All going according to plan with blessings from powers above. We'll soon have banana healthcare but this will allow for big bonuses for Hunt and his stooges in NHSE. One town down, which one is next? Bravo Hunt, you are The Demolisher!

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  • I'm afraid this is what happens if you systemically underfund GP. What we predicted a few years ago is happening now, and it's not just in places like this, it's right across the country. We really do need as much of this GPFV funding to reach front line (ie, the practices) as soon as possible and the emergency funding access to be made much less beurocratic.

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  • Until recently my work has involved visiting practices all over England (no I didn't work for CQC).

    General Practice is struggling everywhere – but my impression was that the most desperate situations in primary care are mainly on the coast - especially in Yorkshire, Lincolnshire and Lancashire - but also, surprisingly, in places like Brighton and in parts of the South West.

    The three underlying causes of the extreme difficulties in coastal regions are similar:

    The patient populations are disproportionately made up of retired people attracted by low property prices and caravan parks. In the North of England, the patients often come from ex-mining or industrial areas and have all the medical problems associated with deprivation.

    The GPs in these areas has been older than average. Many of the doctors either had family roots in an area or came as immigrants thirty or forty years ago. These doctors are heroes and meeting them is humbling - they have often ‘given everything’ to try and keep sinking practices afloat.

    Coastal villages and towns have no professional employment for the partners of the new generation of female GPs.

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  • Not just underfunding but overregulation and too much paperwork in this paperless society. Practices are closing all over the country, some in very stable communities and they are often good practices too. My fervent plea is to dismantle the bureaucracy and let us treat patients without fear or favour. Here's to the heros of Bridlington who remain staunch providers of primary care at the price of their own well-being. Let's hope that they don't get blamed for having too little resilience!

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