This site is intended for health professionals only

GP practice merger delayed for over a year despite ‘working at scale’ directive

Two practices in Lincolnshire have had their merger postponed for over a year after the local CCGs were unable to combine the practices’ patient lists.

A partnership of three GPs have taken on contractual responsibility for two separate GMS practices – one in NHS North Lincolnshire CCG and another in NHS Lincolnshire West CCG.

The GP partners submitted a merger application in May 2016 with the understanding that the partners would operate across the two contracts in the short term ahead of a full contractual merger by 1 April 2017.

A letter from Humberside LMCs to Dr Arvind Madan, director of primary care at NHS England, says the merger was postponed to October ‘due to lack of real support from Lincolnshire West CCG’.

Dr Krishna Kasaraneni, medical director of Humberside LMCs, told Pulse that the delay was due to the CCG’s inability to merge the patient lists.

He said patient lists need to be merged ‘in order for the two practices to truly become one’.

He said: ‘Otherwise if you’re referring patients from one surgery because they’re in one CCG, you have to use one set of forms. For other patients, it’s another set of forms – they’re on different computer systems, so you have to merge both the lists.

‘While North Lincolnshire is being very proactive and looking at how they can do it, including investing in IT systems and so on, West Lincolnshire is saying, we don’t know what needs to be done.’

Dr Kasaraneni added that there is now ‘no chance’ the lists will be merged by the October deadline and the LMCs have been given no indication of how long it will take.

He said in a statement: ‘The national rhetoric has been to work at scale and build resilience into the system.

‘The lack of tangible support from local commissioners who don’t seem to want to facilitate this is hindering general practice, particularly in small, remote areas like Humberside and Lincolnshire.’

The partners have said the arrangement has ‘drained the surgery of significant finances that could have been better spent on improving patient care rather than on duplicating costs’.

Dr Satpal Shekhawat, GP partner at Kirton Lindsey Surgery and Hawthorn Surgery said: ‘As GPs of small rural practices, we know that our patients support this merger and this will improve services to them across both sites.’

He added: ‘In an environment of lack of funding, workforce and ever increasing pressures on general practice, this lack of support and delays is hindering GP services locally and this is not acceptable to our patients.’

NHS England has previously said that they expect ‘100%’ of GP practices – including those in rural areas – to have formed collaborative ‘local care networks’, covering between 30,000 and 50,000 patients by 2019.

A spokesperson for NHS Lincolnshire West CCG said the CCG ‘has, and always will, put patient care first with any process it undertakes’.

He said: ‘We are disappointed with the press release and letter that has been submitted by the LMC – which we think fails to acknowledge the complexity of this process.

‘We have been working and continue to work in partnership with North Lincolnshire CCG and NHS England towards the progression and completion of the proposed merger – while ensuring patients’ needs are met.’