This site is intended for health professionals only

CCG ‘unwilling’ to keep rural practice open, say local leaders

Exclusive: A CCG is being accused of being ‘unwilling’ to pay the cost of keeping a ‘much-loved’ rural practice open, according to local leaders in the area.

Slaidburn Country Practice, a rural 1,100-patient practice in Clitheroe, has been ‘forced’ to hand back its contract because the CCG was ‘unwilling’ to fully fund the practice, and the practice can no longer continue making a loss, according to the local LMC.

Lancashire Pennine LMC told Pulse that ELMS, a GP run out-of-hours provider that runs the GMS contract, has had to subsidise the whole service out of its own pocket for a number of years.

But NHS East Lancashire CCG said the Slaidburn country practice has historically received additional funding ‘due to its rural isolation and size.’

The CCG added that despite the additional funding, ELMS  has ‘struggled to remain financially viable’ and has handed back its contract ending on 30 September.

ELMS took over the practice in 2014 from a single-handed practitioner, who could not manage the running of the practice given the ‘successive’ reductions in minimum practice income guarantees (MPIG), according to the LMC leader.

Lancashire LMC chief executive Peter Higgins said: ‘The LMC is devastated that, despite all our best efforts over the years, there is a strong likelihood that this practice will close. It’s another nail in the coffin of rural life.

‘We are convinced that, given the will all-round, a solution could be found locally to keep the practice viable.’

The CCG has now opened the procurement process for new GP providers for an APMS contract, but the LMC says the bidding is at a ‘much lower contract value’ than what is currently paid and has an ‘impossibly short deadline’.

Mr Higgins added his concerns were that the CCG had ‘all the time in the world’ to sort out the problems with the practices, but have instead created a ‘last minute, cobbled-together procurement process.’

He added: ‘With such short timescales no-one will be able to put forward a credible and robust bid.

‘The solution needs to be local with engagement from the other practices within the primary care network to arrive at a feasible and balanced solution that works for everyone, most of all the patients.’

Mr Higgins also noted that the LMC was not consulted on the service going out to tender, even though the CCG has duty to confer with the LMC on matters concerning GP services.

He continued: ‘The CCG is insisting on maintaining a full morning and afternoon GP presence at the surgery which is simply unaffordable. As a result, we are likely to end up with no service at all as the practice closes and patients are forced to travel long distances, over minor roads, often impassable in winter, to see a GP.‘

The CCG noted they could not comment on the current procurement process.

East Lancashire CCG chair and local GP Dr Richard Robinson said: ‘The health and wellbeing of local people is at the heart of our approach to providing GP services in communities. Locally, people are understandably passionate about the future of the practice.

‘No one wishes to see the loss of a much-valued GP service in Slaidburn, and we are working hard to ensure that this doesn’t happen. We do see this as an opportunity to be creative and innovative in response to the challenge we face, and in doing so provide a service that not only ensures continuity but meets the health needs of local people.’

Recent research found that two-thirds of surgery closures since 2013 were located in poorer-than-average areas.

This comes as GPs working in deprived areas are disproportionately affected by workload pressures, according to a recent analysis.

Meanwhile, a Pulse investigation showed the number of GP surgeries closing its doors has risen by almost eight-fold in the last six years.