Darzi centres set to miss patient registration targets

04 Nov 09

As many as two-thirds of the first wave of Darzi centres to open are on course to miss their registration targets, with many signing up fewer than half the patients they need, Pulse can reveal. Our investigation, marking two years since plans for the centres were announced, reveals even the Department of Health believes it has risked ‘saturating the market’ by rolling them out to every PCT.

Some centres are now looking to renegotiate their contracts to place greater emphasis on walk-in consultations rather than registrations.

Pulse collected registration data from 27 GP-led health centres – of about 80 that have opened so far – and for 15 established the contractual target agreed with the PCT.

Just 33% were on course to meet their target, with centres managing an average of 442 registrations each, and in one case only 109 in six months. By contrast, an average of 6,616 patients per centre had attended walk-in clinics.

The chances of a centre being on target seemed to improve if located in a so-called ‘underdoctored area’. Two of four centres in such areas were on course to meet targets, compared with just three of 11 in areas not classed as underdoctored.

Fears that rolling out centres to every area had been a mistake are reflected in documents obtained by Pulse from an NHS ‘lessons learned’ event.

Dr Mike Warburton, DH national director for GP access, told NHS managers: ‘All 264 procurements were undertaken to the same timetable with a risk of saturating the market.’

Dr Warburton conceded the DH had ‘underestimated the impact’ of the BMA’s Support Your Surgery campaign and failed to allow enough time for public consultation: ‘We should have built in more time at the first and final stages of procurements, particularly for engagement with the public.’

Sue Manifold, practice manager at the GP-led health centre in North Staffordshire PCT, said her centre might have to renegotiate its contract after falling short of registration targets. It has seen 7,055 walk-in patients since April, but registered just 491, despite having a target of 1,200 by the end of the first year.

Ms Manifold said most local patients were happy with their GPs: ‘This isn’t an underdoctored area.’

Dr Sunil Kotecha, a GP running the Darzi centre in Solihull, West Midlands, said it too would be looking to renegotiate: ‘We’ve registered at a slow pace – 400 patients in six months, and we were aiming for 1,500 by the end of the year. But we’re seeing 600 walk-ins a week. We will have to look at the contract.’

Others insisted their centres were doing well. Dr Sally Johnson, a GP at a centre in Ashford, Surrey, said it expected to easily meet its target of 1,000 registrations in the first year. ‘We’ve got lots coming through the door. It’s the only deprived pocket in Surrey, and there was a need for more GPs.’

Dr Louise Irvine, a GP in Lew-isham, south London, who is bidding for a centre, said even in a deprived area such as hers the centre had been sited in an area with ample GPs: ‘They are definitely white elephants. It’s ill-thought-out and unethical, at a time when there are going to be huge cuts.’