GPs warn ICB plans could see homeless patients de-registered
GPs and councillors in Norwich have raised concerns about the local ICB’s plans for a vulnerable adults service, which could mean patients will ‘lose their GP and their surgery’.
Earlier this year, Norfolk and Waveney ICB announced it was shelving plans to change the vulnerable adults service, reduce the number of face-to-face out-of-hours (OOH) bases and close the Norwich walk-in centre, which were intended to address the £280m deficit in the local health services budget.
At the time, following pressures from GPs, councillors and patients, the ICB said it would put in place a new contract for the vulnerable adults service, as the current contract was nearing its end.
Now GPs and councillors have told Pulse that a new specification for the service, shared by the ICB with providers, shows that the service ‘will not register patients and hold a registered GP practice list’.
Dr Heidi Gure-Klinke, a recently retired GP at the service of 22 years, told Pulse that the changes will mean the service’s current patients will be de-registered and moved to other surgeries.
She said: ‘If the new service does not register patients, it means all current patients will get de-registered and moved to a mainstream surgery.
‘This essentially means they will lose their GP and their surgery. It is in essence a closure of a specialist homeless GP surgery through the back door.’
She added that there seems to be ‘a lack of understanding’ from the ICB about what this specialist GP surgery provides on a medical level.
She said: ‘This cannot be provided by a mainstream surgery, so patients would be let down by this new model and this will have a significant impact on their recovery journey.
‘They will relapse, end up getting more costly treatment via ambulance and A&E and even die due to lack of access, continuity of care and specialist GP care.
‘It is not clear if non specialist surgeries are ready for providing a safe service for this complex challenge, as they have always advocated for a special homeless clinic. There seems to have been no consultation with patients, the service, other surgeries or the local council.’
The specification also suggests that the hub will provide ‘intensive support’ to patients for six weeks before they move on to another practice.
Dr Gure-Klinke added: ‘How can an a homeless person who has multiple physical, mental health and addiction issues be properly assessed within six weeks and moved on?
‘Homeless patients are difficult to find, to engage and to assess. This process takes at least a year, including supporting patients to come in for appointments, getting referrals done to various services and supporting patients to see specialists.’
Green party councillor Lucy Galvin said: ‘This is a crucial surgery for the city and county, which saves money by getting effective and specialist medical care to patients.
‘These proposals need to be scrapped once and for all, as they would have huge impact on the people who need care most – and an unwanted, unsafe and expensive knock on impact on other services.’
The ICB did not deny that the new service will not hold a patient list and that the service’s current patients will be moved to other surgeries.
A spokesperson for Norfolk and Waveney ICB said: ‘We are in the process of putting in place a new contract for the Vulnerable Adults Service and are currently going through the procurement process.
‘We can confirm that the service will remain GP-led and that patients should notice no difference in the intensive support they receive.’
Earlier this year, Norfolk county council’s health overview and scrutiny committee (HOSC) voted to ‘call in’ the ICB’s consultation on the services to health secretary Wes Streeting, arguing that it was ‘not fit for purpose’ – before the plans were abandoned altogether.
The ICB said that the decision to abandon the plans was made because ‘the situation has changed’ since the start of the consultation, and that going forward it is planning to put ‘a greater emphasis’ on neighbourhood health, in line with the Government’s 10-year plan.
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