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CCG bans patients from leaving hospital-managed GP practice amid exodus

GP patients in Gosport have been banned from switching surgeries after a dramatic exodus of patients from a hospital-managed GP practice left others overwhelmed.

The Hampshire town has seen 2,100 patients transfer to different practices after problems at the four-practice Willow Group, managed by Southern Health NHS Foundation Trust.

NHS Fareham and Gosport CCG, which took the decision, said the three-month restriction will remain in place until 31 March.

The Willow Group was formed in April 2017 when four practices merged with Southern Health NHS Foundation Trust, with GPs becoming salaried to the trust, in a bid to avoid closure in light of severe recruitment problems.

The blanket ban on moving GP comes after two Gosport practices closed their lists after struggling to cope with the sudden increase in numbers. This led to a knock-on effect on nearby practices which raised safety concerns.

As a result the CCG decided to stop all transfers until April, when it is hoped the GPs will be under less pressure.

CCG spokesperson Dr Andrew Holden said: ‘We are not taking the decision lightly to support temporarily suspending a patient’s ability to move to another GP practice. But the current situation poses considerable risks.’

Urgent action was needed to prevent new arrivals in the area being left in the lurch, he said.

‘If more practices suspend patient registrations, then people moving into the area may not be able to find a doctor at all, which is unacceptable. We are also very mindful of practices’ concern that they could have a list size that is unsafe to manage.'

He added: ‘This temporary suspension will give the practices some time, in a planned and co-ordinated way, to catch up with the influx of patient registrations received to date.’

Dr Holden said that allowing patients to move in order to find quicker appointments was no longer a solution.

‘We would ask patients to bear with us at this time and understand that, if they are considering moving practice, for whatever reason, that all of the practices are committed to providing the best services they can.

‘The shift in patient numbers means that a practice which, a few months ago, could potentially offer a faster appointment than elsewhere may not still be able to do so.’

Dr Nigel Watson, chief executive of Wessex LMC, said the Willow Group had lost a significant number of partners in a short space of time, then struggled to replace them, meaning that patients couldn’t get appointments with the result that they re-registered elsewhere.

And, although it’s not unusual for practices to sometimes close lists, it was unusual for a CCG to put in place a blanket ban on patients moving surgeries, he added.

Dr Watson said: ‘Where it’s unusual is the blanket ban on people. In hindsight you always wonder what you can do differently. Ultimately we have got to address GP workload issues [for the profession in general] because we’re driving GPs away.’

Gosport MP Caroline Dinenage, a health minister, has told local media that constituents raised concerns throughout 2018 about the Willow Group. She said the complaints were about a lack of appointments and problems with the telephone system.

Dr Robin Harlow, GP and clinical director at the Willow Group, said: 'We are working closely with our colleagues at the CCG and the other surgeries in Gosport to stabilise the situation, support each other and enable patients to move freely again, should they choose to.

'GP recruitment and retention is a national issue and one which is being felt particularly hard in Gosport. This has created challenges with patients accessing primary care in the area which is why we continue to invest in, and explore, new ways of working for our patients.'

He said this included investing 'significantly' in a new telephone system 'to improve access', and apopting 'new technology such as E-Consult, which we strive to respond to on the same day'.

The Willow Group has also developed an 'extended primary care team', which manages people with long-term conditions and 'offers patients the opportunity to see other health professionals that might be more appropriate for their needs'.

The news comes as a Pulse investigation last year revealed that the number of GP practices closing their lists to new patients had started to taper off, after rising for several years.

A freedom of information request to NHS England showed 106 GP practices closed lists to new patients in 2017/18 - compared with 145 in 2016/17 and 175 in 2015/16. 

Readers' comments (24)

  • I'm intrigued how a new telephone system will help when the problem is a lack of doctors.
    I suspect that working as a GP in one of these large groupings is less satisfying than being part of an autonomous mid sized practice where you can feel in control.

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  • I feel for the local practices and the staff in the one haemorrhaging patients...sadly there will be more of these unless the toxic working conditions leading to GP recruitment, and retention problems are addressed effectively.. I won't hold my breath!.
    Like others, my reaction was surely it must be illegal to prevent people from registering elsewhere but,rather conveniently, it seems there is wriggle room contained in the small print surrounding having ' good reason' to do so.
    The NHS Constitution concerning choice and GP services says:
    "You have the right to choose your GP practice, and to be accepted by that practice unless there are reasonable grounds to refuse, in which case you will be informed of those reasons.
    With regards to how this particular CCG bar on registration movements might have been arrived at I see that, whilst it is a legal duty and they must " have regard" of & consider the NHS Constitution when exercising functions, in fact this is a procedural duty only. Apparently it is not unlawful for an NHS body to act in a way that contravenes the NHS Constitution provided they can show they 'have considered the relevant provisions very carefully' and have only departed from it for 'very good reasons'.
    Hmmnnn!

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  • Do You think the funding of the APMS trust contract is being reduced as the patient numbers reduce, bet not, bet they are getting more than us mere plebs.The system is totally corrupt.

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  • Neil Bhatia

    They can't possibly do that.
    The CCG could facilitate a "ban" in all but name by permitting all local practices to close their lists. That effectively prevents practices *registering* at another local practice.

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  • Neil Bhatia

    sorry, that prevents PATIENTS *registering* at another local practice!

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  • Took Early Retirement

    Southern Health again..... just google them for a look at their record.
    I find it very funny, in a schadenfreude sort of way.
    Gosport, medically speaking, is a complete dump. Huge sink estate at Rowner. High-demand, high-workload, low-remuneration sort of General Practice. Caused, mainly, by GPs voting yes to the last contract, which was not workload-sensitive. You reap what you sow, and the BMA sowed it for you.

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  • Yes, I thought so.

    The same group of four practices lauded as a case study for merging same-day services in the NHS GP Forward View of April 2016.

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  • Vinci Ho

    I understand and sympathise that practices had to merge together and let another organisation to take over the governance ,as the last desperate move to survive under this hostile environment created by this government.
    But the reality is candid and cruel : merging together and working by scale simply swept the dirt under the carpet. The running model of general practice before these austerity measures imposed by the government(s) remains the most cost-effective, in my opinion . That obviously takes into the account that the crisis of retention and recruitment is also directly caused by this ‘hostile environment’.

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  • Seems the only way to survive as a GP these days is to restrict access
    Must be a better way but fundamental lack of GPs a major problem
    Perhaps a substantial pay rise might help as well as easing the restrictions on pensions and reinstating seniority pay
    Like removal of the nursing student bursary these changes could not have been more toxic if the government has tried to demolish general practice
    Oops maybe that is the plan ?

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  • This is happening in other areas of Hampshire. A patient told me the other day that she had rung her surgery 26 times that morning to get an appointment for her 7 year old daughter - this was a surgery run by IMH, and she said it happened all the time. Obviously she could be lying but she showed me the "26" on her phone! I asked why she didn't change GP's, and she said that all the surgeries nearby say they are not taking any new patients and that their lists are capped. Although the CCG says this is "not allowed", actually why should all the other surgeries topple because of that one's incompetence? Expecting them to deal with dangerously high workloads in which patients come to harm and then sue is so unjust when the original cause of the workload is greedy incompetent idiots - I believe the current or certainly recent manager of this particular practice used to manage a B and Q - who have so understaffed their surgery that the good doctors who used to work there have all left.

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