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Independents' Day

Single-handed GPs asked for 'continuity plans' in case of their death

Exclusive NHS England has asked GPs in Cornwall to detail their practice continuity plans in case they die, which local GPs have branded as ‘crazy’ and ‘unfair’.

In a questionnaire sent out by NHS England, single-handed GPs were asked for their continuity plans 'in the event of death of the contract holder'.

NHS England said the form aims ‘to ensure the continuity of service provision when a contract is held by a single-handed GP’.

NHS England sent out the ‘Single Handed GP Contractor Assurance Framework’ form, which was drawn up locally by NHS England South West, to practices in Cornwall in April.

The 11-question survey, seen by Pulse, asked GPs for the number of staff working in the practice and the number of GP sessions offered each week, in addition to practice continuity plans.

The form, which it says is ‘based on national policy’, asked: ‘What are the practice business continuity plans in place in the event of death of the contract holder?’

The form references sections of the GMS and PMS contracts which state that a contract 'must terminate at the end of the period of seven days after the death of the Contractor unless, before the end of that period,' it has been confirmed in writing to NHS England that 'they wish to employ or engage one or more general medical practitioners to assist in the continuation of the provision of clinical services'.

Dr Bruce Hughes, BMA GP Committee regional representative for south and west Devon, Cornwall and Isles of Scilly, said: 'While all small businesses should have contingency plans in place, and commissioners will want to ensure the continuity of future patient care should anything happen to practices, it seems unfair to single out lone partners in this way. We have taken this matter up with commissioners locally.

'Across the South West there are a number of practices on the brink, but these are not necessarily run by single-handed partners. NHS England needs to work alongside LMCs and CCGs to address the wider crisis facing general practice.'

A single-handed GP in Cornwall, who asked to remain anonymous, told Pulse: ‘It seems pretty crazy that I have to answer what plans to make for the practice if I was say to be killed in a car crash. I feel this is a very unfair thing to ask and very difficult to answer.’

But an NHS England South spokesperson said: ‘Our duty is to make sure patients continue to have access to primary care.

‘Single-handed practices can be particularly vulnerable to events, so it’s in everyone’s interests to make sure robust continuity plans are in place for all eventualities.’

A letter, sent to GPs alongside the form, added: ‘Our aim is to develop a consistent picture of each practice and to deal with similar contractors in a consistent way. 

‘Once the form has been returned the information will be reviewed, within NHS England and your CCG. For some practices, there may need to follow up and discuss future plans, but if this is the case you will be contacted to arrange a mutually convenient time.’

Pulse previously reported that one-fifth of practices in Plymouth have either closed or handed back their contract in the past three years, leaving 34,000 patients without a fixed GP, and putting pressure on neighbouring practices.

And a Pulse investigation last week revealed that 450 GP surgeries have closed in the last five years, displacing 1.3m patients.

NHS England has previously been accused of failing to preserve distressed practices if they had fewer than 4,000 patients.

Readers' comments (31)

  • It’s a clinical governance issue . Any GP at risk of death without a robust plan should be suspended and reported to the GMC immediately. You could not make this up

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  • Just Your Average Joe

    NHS England - your plan on your death involves passing your list onto a larger local practice who have a nice new building and fit our vision of the future better. What can we do to hasten your demise?????

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  • Dear All,
    How stupid are they? The contract self destructs 7 days after the contractor dies. That means its NHSE's problem. If they understood the issue they'd be sending the form to themselves!
    Oh of course, foolsih me, they'll just dump the lot onto the nearest practice for nothing or make a "management decision" to give extra money to a non NHS provider to run the service for a year and then hand it back to the NHS.
    Paul C

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  • I understand the need for continuity but as Paul points out, that's commissioner problem, not provider.

    You watch - we'll all soon get an email asking us to submit business continuity plans on what happens if we all die at practice Xmas party (GPC to negotiate terms of banning this from 2019/20)

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  • Dear semi-retired,
    The powers that be almost certainly will sue you for not having a plan in place but conversely couldn’t we sue them for not having a robust plan in place too?

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  • Normally a diehard scourge of numpties and jobsworths, I am 100% behind NHSE on this one.A single handed GP isn't flogging widgets, he or she is providing care to patients and should either mitigate the risk by taking on Partners/assistants or hand in his or her contract.My concern here is for the patients and not the doctor.

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  • 1:34- Fly Robin, fly.....Up, up in the sky.
    It's always great having helpful comments from non Partners regarding partners! You do have to be a Partner to see the funny side of NHSE antics:)

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  • AlanAlmond

    Robin Jackson, I asume you have a robust plan in place to cover your employer for the inconvenience they might suffer if you inconsiderately get run over by a bus tomorrow (heaven forbid I sincerely hope nothing of the sort will happen) for someone will have to see the poor patients who were booked into see you. You presumably have a contract with your employer to provide doctoring services, just as your employer has a contract with the CCG. Maybe there are other staff in your surgery who you asume will cover, what about practices who don’t have this kind of staffing luxury? Or perhaps you feel this logic not extend to you?

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  • Robin Jackson
    What a caring Gp you are. I wish you were single handed Gp and know in’s and out’s of single handed practice
    Even in your death you thing of your patients who may die if lack of med3 or there routine script. You must have saved many lives in your routine surgery

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  • Ha ha ha ha
    Dear NHSE,
    When I die, my plans are to continue to remain dead (if that's ok with you of cause).
    Btw, with all that grand vision of bigger picture that you've got, what are yours?
    Best wishes

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