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Independents' Day

CCG to cut urgent care centre hours following GP at Hand deficit

The CCG hosting GP at Hand has unveiled plans to cut urgent care centre hours due to its ‘very challenging financial position’.

NHS Hammersmith and Fulham CCG is reportedly facing a £31.8m deficit due to pressures caused by tens of thousands of patients registering with GP at Hand, which makes the CCG responsible for their wider care costs as well as increasing the practice's global sum funding.

As of mid-March, over 47,000 patients were registered with the digital-first NHS GP service, of which only 10% were from the host CCG.

The CCG’s plans would close the urgent care centre at Hammersmith Hospital overnight from midnight until 8am, and close two GP hubs which provide evening and weekend GP or nurse appointments.

A public consultation is underway for the plans, which would leave one urgent care centre available 24/7 in Hammersmith and Fulham, and one GP hub to cater for 231,004 registered patients.

The CCG said on average 48 patients a week use the urgent care centre in Hammersmith Hospital, and 72% of the hub out-of-hours appointments are used. It estimated that closing two hubs would save £265,000.

It comes after warnings that the CCG’s deficit could ‘lead to practice closures’.

An NHS Hammersmith and Fulham CCG spokesperson said: ‘The CCG has a very challenging financial position and has reviewed all of its areas of spend in order to ensure value for money and reduce costs where possible.

‘We have made clear in the consultation document that whilst the financial situation is key, these are services which are underused. The CCG has been through a thorough clinical assurance process and had confirmation from the London Clinical Senate and NHS England that they do not believe the proposed closure over night of the Hammersmith urgent care Centre or the proposal to reduce the number of hubs increases the clinical risk for patients.’

The CCG said that many practices within the borough also offer weekend and evening appointments, which would help cater to demand.

The spokesperson added: ‘The changes that are proposed will save money but more importantly mean that we are achieving better value for money based on the current utilisation of the services. These potential savings will contribute to the CCG’s savings plan for 2019/20 if they are formally approved by the Governing Body once the consultation has finished.’

However, Hammersmith and Fulham council’s cabinet member for health and adult social care, Councillor Ben Coleman, said: ‘Even though out-of-hours GP appointments at the hubs are poorly advertised, 260 people a week use them.

‘And cutting Hammersmith’s overnight urgent care centre, which is used by nearly 50 people a week, goes back on the promise health bosses made then they closed Hammersmith hospital’s A&E.’

He added: ‘They will make things more difficult for residents and just shift costs to Charing Cross hospital – and there’s no plan for how it will cope with the extra numbers.’

An Imperial College Healthcare NHS Trust spokesman said the trust intended to respond to the consultation, but that they believed the plans would have ‘little impact’ on staff and patients.

‘We are confident that if the proposals do go ahead we will be able to accommodate them with very little impact on patients and staff.’

It follows a Pulse investigation which found that the number of shifts without GP cover at out-of-hours services was rising, alongside the number of serious incidents.

Readers' comments (5)

  • Just me I'm sure but isn't £265k saving making "very little impact" on the £31.8 million deficit???

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  • 48 patients a week
    2500 appointments a year
    that's £106 per appointment

    that's more than capitation payment for GP to look after single patient for a year, unlimited appointments, free buffet

    no wonder they're shutting it down!

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  • Dear All,
    What splendidly astute decision making by the CCG, facing a £31,000,000 debt from a service they approved catering for 47,000 patients. The answer is to close a service costing less than 1/10th of GP @ Hand treating a population 4.8 times as large. All the financial sluice gates are fully open so we'll stop watering the window boxes. Pure management brilliance.
    PauL C

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  • Just Your Average Joe

    31 million to treat 47000 patients makes GP at hand look like it cost £659 a patient a year to run - if you assume the deficit is purely down to the change in service provision.

    Even the hub and walk in service was expensive but not such poor value.

    Robbing GP core services of funding - to pay for the worried well in either type of service is management allowing common sense to be sacrificed at the alter of demand.

    Not a single actually genuinely sick patient will be dealt with successfully by phone - as all you can do for those is signpost to another more appropriate service, where the costs are duplicated.

    If they were seen there without the original costs - savings would be made.

    The NHS should be free at the point of need, not free at the point of convenience.

    If services like GP at hand are allowed - it should be private only at the cost and convenience of those who pay.

    Core GP services should be returned to the Primary care base - where real patients are physically based, so funding is not jeopardised for the rest of the population.

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  • Totally agree with above. 31.8 million is a massive amount just to be accounted for by GP at hand ..

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