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Four practices to close in Plymouth for not fitting with 'national blueprint'

NHS England has decided to close four GP practices in Plymouth because their ‘relatively small size’ is not a fit with the 'national blueprint' for 'the direction of travel'.

NHS England (South West) said it was 'moving ahead with a series of changes to the way GP care is organised in Plymouth' which will see the GP practices at St Barnabas, Hyde Park, Cumberland and Saltash Road - which between them have just over 17,500 patients on their lists - close at the end of March.

Among reasons behind the decision, NHS England listed 'the direction of travel set out in the national blueprint, the General Practice Forward View, which recognises the pressures and points towards a future in which surgeries operate "at scale" rather than as separate, small businesses'.

The news comes despite NHS England rejecting claims last month that it is allowing to fail. As revealed by Pulse, a senior NHS England official said vulnerable practices must ‘transform…or be allowed to fail and wither’, but a press office spokesperson said the comments did 'not reflect national policy whatsoever’.

A total of seven Plymouth GP practices were at risk of closure, after previous providers handed back their contracts, but NHS England has decided to tender for new providers for the practices at Ernesettle, Mount Gould and Trelawny, and a new practice at Barne Barton.

Access Health Care, a subsidiary of Devon Doctors, is temporarily running all existing seven practices until the contract runs out in March. NHS England is planning for the remaining three practices, and the new practice, to have new contractors from 1 April.

In a statement, NHS England emphasised that the closure decision was taken separately for each practice, but they had some common factors including ‘the relatively-small size of the practices’, which 'makes them unattractive to would-be providers who would take on the financial risk of running the business at a value of £76.44 per patient per year’.

NHS England also said that the size makes recruitment a difficulty, as 'young doctors prefer to be salaried or to work as locums, working within larger practices, which makes it particularly hard for small practices to recruit'.

The statement said: 'In the case of all seven existing surgeries, the previous provider had stepped away because they could not sustain the service. A temporary provider was appointed to provide breathing space, while the longer-term future was considered.’

They decided there was ‘no realistic prospect’ of getting a new provider for the closing surgeries ‘in the face of rising workload and financial pressures’. They also said that most of the patients would be able to move to one of 20 practices within a two-mile radius.

Amanda Fisk, director of assurance and delivery for NHS England in the South West, said they had considered 'every single comment' made in a public consultation about the future of the GP practices, which had showed 'very clearly how much people value their local surgery'.

But she added that 'unfortunately, when weighing up all the factors, the reality of rising pressure on general practice led us to conclude that we would be unable to find anyone who was both willing and able to keep these surgeries open'.

Dr Stephen Warren, a GP at Hyde Park Surgery, told the Plymouth Herald: ‘I think it's unwise to close four GP surgeries at once...I did my best to warn NHS England, but my warnings haven't been heeded.’

‘We were a five-star surgery and yet the current recruitment issues mean long-term sustainability was in question.'

Are small GP practices being run to the ground?

Comments made last month, in a briefing sent out by Paul Twomey, medical director of the Yorkshire and Humber area team, had indicated that NHS England would a allow GP practices to fail if they did not 'transform appropriately' in line with Forward View plans.

He said that NHS England is ‘no longer in a position’ to continue supporting vulnerable practices, but NHS England said letting practices fail was not national policy.

The statement from NHS England's South West regional team refers to the GP Forward View, the general practice rescue package published by NHS England in April.

This said that 'larger organisational forms will enable greater opportunities' for GP practices and have them working from 'a more effective platform', integrating with other health and social care providers.

It also promised an extra £40m ‘resilience’ fund for vulnerable practice, with £16m available this year, but despite this practices are continuing to close.


Readers' comments (18)

  • The pharmacist troll is back with the chip on shoulder about GP pensions.

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  • More practice closures, what a shame!
    I actually read the GP forward view (I need to get out more)

    It does actually promise £2.4Bn per year INCREASE in funding for general practice. Thats about £80K per GP per year inc in funding.
    If we and these poor practices actually got this money, they might stop closing

    We've seen nothing of the sort -no increase, just more bureaucracy and penny pinching.
    The only winners are likes of Capita.

    All very well saying GPs have to merge / federate, but no evidence that merging actually saves any money. Most GPs practices are run on a shoestring- just support them. Its not the GP system that's broke.

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  • agree the salient point is the criminal underfunding of gp and the nhs by this stunningly out of touch corrupt and evil simple this how you propose your pathetic tissue of blue sky platitudes called the five year forward view will take gp be followed by the universally ridiculed as utterly impossible STP secret plans?
    ps are you aware you are a public servant spending our taxes?
    it is totally unacceptable that the s STP conspiracy is occurring without public absolute national disgrace.
    like should resign.

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  • I have worked at one of these practices as a long term locum since July 2015. The partner resigned his contract after having health issues but stayed on working. It is profitable to our current contract holder- Access Health Care, is loved by our patients and gets great outcomes/QoF scores. The ex-managing partner complained and fought this, as did the whole patient body of 2800. We called NHS England out on their misleading comments-1)that they were running a consultation on what to do with our practice- the consultation letter was received by patients the DAY before the consultation on the 25th August at 10am! 2) The letter said that they had decided to close the practice- so what were they actually consulting on? 3) The letter said that local practices has space for our patients. Many of the practices have open lists for patients moving in and out of the area but have written to NHS England stating that they do not have capacity for 2800 patients! As GPs we were committed to remain at the practice- hoping for a salaried contract but neither of us had the energy or desire to provide excellent quality care AND run the practice. It is more than a full time job to do both well and I did it well for 9 years then could not do both. The managing partner was reprimanded by NHS England for unprofessional conduct! It is such a shame that excellent caring practices are shutting and it is getting so much harder for everyone else.

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  • N Ireland and Oxfordshire are looking at handing back the NHS contract. Why doesn't the LMC in Plymouth do the same, and if the practices are valued stick 2fingers upto the NHS and go private.

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  • The so called direction of travel is to close down smaller GP surgeries so we patients all have to register with very large group practices. I think this is a symptom of severe underfunding of the NHS. This has happened to me. I am thinking of finding another practice because this one invited me to join the electronic prescribing scheme so that I would not have to ask for a repeat Rx every month but could renew it every four months and in the interim collective my 3 drugs straight from the pharmacy, but here we are 2 months later still having to ask at reception every month for a repeat Rx. We should demand that smaller practices are maintained and sack NHS England for closing them down. For decades the Tories maundered on about giving us choice but now we have no choice except to register with over large and inefficient practices. Is it a plot to get us all to go to private doctors?

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  • Conform or die.

    There's an -ism for that is there not?

    Stuff it, they will only miss us when we are gone. And maybe not even then.

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  • Late comment! Do any of you remember the misquoted advert for the Fiat Strada many years ago?
    'Designed by computer, built by robots and driven by morons'!!
    Has the NHS taken its cue from this advert because it seems somewhat prophetic for todays NHS?!

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