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GPs go forth

CCG axes GP minor injury service amid warnings of 'morbidity and fatalities'

A CCG is set to cut all funding for a GP minor injuries service, in a move local GPs argue will incease the risk of 'major morbidity and even fatalities' by forcing patients to travel up to 40 miles for treatment. 

Last week, NHS Hambleton, Richmondshire and Whitby CCG announced that GP practices would ‘no longer be contracted to provide enhanced minor injury services’ from 1 April, arguing that it has not been consistently available across the region and was only used by a small number of patients.

However, GPs warned cutting the enhanced service - which pays practices to cover minor ailments that would otherwise be treated in A&E - will only put extra strain on GPs, with practices being forced to stretch their own resources to 'fill the gap'.

In a letter to the CCG, seen by Pulse, partners from Central Dales GP practice in Leyburn called the situation 'wholly unacceptable'.

The letter said: 'We are frankly shocked that this has happened with no consultation with practices and find the explanations given for the decision devoid of any common sense or regard for the realities of primary care in our remote parts of the area.'

'We have a long history of providing a minor injuries service to our patients, recognising the distance and inconvenience of a trip to a casualty department almost 40 miles away.

'We know that providing a service here means our patients do not delay seeking treatment because of the time and distance and that injuries remain minor as a result rather than becoming infected and complicated and needing secondary care admission/intervention,' it continued.

The letter then warned the CCG that to 'proceed with this decision not only inconveniences patients but provides a far poorer service and increases the risk of major morbidity and even fatalities by reducing access to a service which works well locally'.

A spokesperson from the CCG said: 'We acknowledge that some patients may experience inconvenience, however the CCG would not proceed with this change if we thought there was a risk of major morbidity and fatalities. Patients who are seriously ill would more likely be seen by emergency services and would not access minor injuries.'

Chair of Leyburn medical practice participation group Dr Nigel Watson also wrote to the CCG.

He said: ‘It will place additional pressure on A&E services and it erodes the goodwill of practitioners who will be under pressure to utilise their own stretched resources to fill the gap.’

The letter continued: ‘It is regrettable that patient services are being eroded in order to fund the CCG’s deficit. While we recognise the CCG’s financial difficulties, we regret the adverse impact on patients.

'Fundamentally, we believe that the ultimate responsibility for this erosion lies with the Government, and we would ask that you press the health secretary and NHS England to provide sufficient resources to sustain patient services.’

In response, Hambleton Richmondshire and Whitby CCG interim finance director Jim Hayburn said: ‘Because the enhanced minor injuries scheme is delivered by general practices under contract, we have to take a consistent approach across the whole CCG geography.

'When we reviewed the enhanced minor injuries scheme, we discovered it deals with a very small number of patients who were not spread evenly through the CCG and that in some areas there were already existing services available. This is especially true of Northallerton and Whitby.’

Other local areas have also seen minor injuries services put at risk.

Last year, GPs in Wirral opposed their CCG's decision to close the region’s walk-in centres and minor injury units.

Readers' comments (7)

  • Let’s hope the practices learn to say NO

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  • As above
    MUST say no.
    Use it as an opportunity to review what else you should be saying no to. Anything related to a catheter is a good example.

    AND use it as an opportunity to decide if other enhanced serviced are undervalued and need to be declined. E.g. EVERY surgery declining to take blood would be interesting.

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  • Send them 40 miles then. Even a tick bite

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  • Vinci Ho

    I think all these minor injury units( and walk-in centres) are all at risk of CCGs’ closure decisions. It was ,perhaps, always a consideration amongst these commissioners in CCGs for cutting cost to balance the stifling budgets set by our friend,NHS England ( aka Ministry of Plenty) . At least , the opening hours were to be reduced.
    You see , if the four-hour A/E target is to end ( replaced by whatever so called new priorities) , people with presumed minor injuries can just sit in A/E for long time ( or eventually walk away). Hospitals do not need to worry about penalty for not meeting the target anymore . In fact , there is no political pressure or urgency to sort out this cohort of patients. May well just close all these minor injury units in the community to save money , ha ha ha (laugh from Lucifer ).

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  • Vinci Ho

    Ah ,PS
    Just ask GP networks to deal with them , la.

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  • Wasn't it a National DES?
    IE they can't stop it.

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  • Where else will the belt tighten? CCGs are going to have to balance the books somewhere? And yes, patient care will suffer, but can't run a deficit forever! Question where next hospital cuts too...

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