GP workload concern after ICB fails to reprocure community gynaecology service

GPs have raised concerns after their ICB decided not to reprocure a local community gynaecology service, leaving patients ‘in limbo’ and increasing workload for practices.

Provider Primary Integrated Community Services (PICS), owned and run by GP and practice partners in Nottinghamshire, stopped delivering its service at the beginning of this month, having served notice to the ICB in May.

According to communication sent to practices by PICS and seen by Pulse, Nottingham and Nottinghamshire ICB will ‘not reprocure a like-for-like service’ and ‘staff have been made redundant’.

For patients on the follow-up list from the service, the ICB has decided to ‘return these patients back to their practice’, PICS added.

This means that all 1,750 patients who have been seen in a PICS consultant led clinic who need a follow-up appointment will be transferred back to practices, as well as all patients waiting for the outcomes of any diagnostics to determine the next steps in their care.

GPs told Pulse that the move means patients have been left ‘in limbo’ and that this could cause pressures for practices.

The service provided an ‘alternative community setting’ for first and follow up appointments and appropriate procedures, reaching women ‘earlier and in a more accessible way’.

A Nottingham GP, who wished to remain anonymous, told Pulse: ‘Sadly the ICB have stopped this service without adequate notice to patients and GP surgeries.

‘This has caused unnecessary stress for patients who have been referred into the clinics or are awaiting investigations.

‘There is no set plan about how they will be managed now. Ideally the ICB should transfer the care of these patients directly to the replacement specialist service.’

In a message to practices, PICS medical director Dr Neil Fraser and managing director Karen Frankland said: ‘We will continue to work with the ICB and are very keen that the PICS patients are not leapfrogged by new referrals into any new service offer.

‘This is not how PICS wanted to see the exiting of the service and we want to work with practices to understand how you want to deal with this transfer of care. We absolutely understand the pressure this could put on your practice.’

The ICB said it has started a review into community gynaecology services across Nottingham and Nottinghamshire.

The ICB’s director of delivery and operations Maria Principe said: ‘PICS have served notice on the community gynaecology service contract for Nottingham and South Nottinghamshire. We are working quickly to set up alternative arrangements to ensure that care continues.

‘We have also started a review into community gynaecology services across Nottingham and Nottinghamshire so we can create an equitable service in the longer term for all our communities.’

According to the ICB, the commissioner is now working with GP practices ‘with a view to them providing’ a pessary fitting service ‘in the future’.

‘Under the new arrangements, patients would either have this done at their own GP practice or another one nearby,’ the ICB added.

Earlier this week, NHS England urged pregnant women to use a service to self-refer directly to local maternity services, without seeing a GP first.