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'Vanguard' practice seeks takeover by hospital due to unsustainable workload

Exclusive A successful ‘vanguard’ practice is in talks about becoming a salaried service under the local trust’s control because its workload has left partners on the brink of ‘physical and emotional collapse’.

The Brune Medical Centre in Gosport, Hampshire has approached Southern Health NHS Foundation Trust about a potential takeover.

The 9,000 patient practice has three whole time equivalent GPs, and has been unable to recruit partners or salaried doctors for three years and have increasingly used nurse practitioners to cover gaps.

Local leaders have said that practices in the region are looking to develop formal mechanisms to allow them to move to an employed model under secondary care control due to growing interest.

This would be partly done through the South Hampshire Multispecialty Community Provider (MCP), which includes Brune Medical Centre plus 29 GP practices and Southern Health itself.

It is one of the ‘new model of care’ vanguards devised by NHS England, which sees GP practices and hospitals working together in larger organisations providing both primary and secondary care.

GP leaders have warned that the new models of care could lead to practices being ‘devoured’ by hospitals.

The majority of practices in the MCP vanguard remain independent contractors, though they are developing a new framework which would allow merged practices to be contracted as a provider arm of the trust.

Southern Health last year made arrangements to take on the staff and premises of another struggling Gosport practice, and said that ‘three or four’ Hampshire practices had expressed interest in a merged arrangement with them.

Brune Medical Centre’s senior partner Dr Stuart Morgan told Pulse that being part of the vanguard has helped the practice, but they could not ‘hold on’ until pressures abated.

Dr Morgan told Pulse: ‘We’re a popular and highly regarded practice locally, and yet we have succumbed. It just shows how vulnerable practices are, even medium-sized practices such as ourselves are vulnerable. It only needs one resignation or one retirement for the whole house of cards to come tumbling down.’

’While one would like to hold on and hope things would change through vanguard, and I’m sure they will, it’s too late for us.

Dr Morgan told Pulse they had turned to Southern Health because they ‘don’t want to hand back our contract and open up a tendering process, potentially including private sector providers.’

He added: ’It’s more than burnout; it’s reaching the point of physical and emotional collapse due to the sheer overwhelming pressure of workload.’

Dr Nigel Watson, chief executive of Wessex LMCs, told Pulse: ‘Part of the solution for [Brune Medical Centre] and others is, we’re looking at developing an employed model.

‘So the partnership model can survive, but those who would like to move to a model where the risk of property ownership and managing staff goes, where they’re paid a salary and work with other organisations, is possible.’

What support is available to practices facing closure?

Stop Practice Closures-logo-online-330

Copy of Stop Practice Closures-logo-online-330


 Pulse has been calling on NHS England and the Government to make emergency funding available to practices on the brink of closure through its Stop Practice Closures campaign.

After almost three years, NHS managers took note, revealing a £10m rescue fund which could be used to support 600 of the country’s most vulnerable practices, by parachuting in IT and managerial support.

However with surgery closures hitting three-year highs, GP leaders have warned it could be too little too late.

Readers' comments (18)

  • lol, after the shiny new toy loses it's sparkle after 2-3 years it will be tendered out anyway, because only GPs will put up with the pressure

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  • Dear All,
    This is the point i've been making all along, the shiny "Vanguards" and New ways of working (sic) are not being driven by a desire to innovate or improve they are being driven by the instinct to survive. Its unfortunate that despite Nigels best and sustained efforts its not worked out.

    The bottom line is I cannot see anythuing working anywhere without a large dollop of money.

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  • The NHS is broke and broken. All these toys are about maintaining plan A - an NHS funded solely by tax and free at the point of delivery, achieved by working you and I to death.

    We must stop wasting our valuable time, energy and mental capacity on plan A and focus SOLELY on plan B - a service where co-payment ensures adequate funding, rewards those who deliver services and manages demand to appropriate levels.

    Vanguards - Fantasy
    MCPs - Miles away
    ACOs - fine, but when?
    Federations - a means to an end, but not the end itself.

    Folks, WAKE UP. You need more cash to deliver the volume of work, without a plan to deliver that, walk away.

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  • John Glasspool

    Well, for anyone who doesn't know it, Rowner is a hopelessly deprived area in an already high-demand inner-city type environment.

    HOWEVER, things must be REALLY bad if they want to be taken on by this trust!!!!

    http://www.bbc.co.uk/news/uk-england-35234417

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  • John Glasspool

    Another link

    http://www.bbc.co.uk/news/uk-england-35268654

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  • Practice Manger @7.04: Quite so!Its not 1949,it is 2016.Patients are not dying in the streets of Bonn or Bordeaux because their health services are not "free at the point of delivery".Unfortunately as soon as someone like you suggests shifting the paradigm we are deluged by agit prop "evil Tory plot" placard wavers.
    Do the maths: GPs leaving v. trainees joining: General Practice as we know it will not exist in 10 years time so.....read the Steven's Report.This is your template to turn the tables and take over Trusts, not vice versa.Flog your semi-converted Edwardian terraces to Mr Barrett,pull in the public to back your shiny new Health Campus, threaten your MPs with a de-selection campaign if they fail to persuade the Local Authourity to release land, and find a developer to build your clinic at zero cost on the back of 50 new homes on the released land....or stop whingeing and buy your one-way ticket to the Antipodes.

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  • ... think i'd prefer to carry on whingeing and buy my one-way ticket to the Antipodes quite honestly

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  • i wonder if Physician associates and in-house pharmacists would help.

    perhaps resilience training and innovation (use of skype) might help?

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  • ... also a mental health worker at the site might be useful

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  • How about JUST SAY NO TO UNNECESSARY DEMAND and those partners will cope just fine.

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