Two GP surgeries are set to close due to problems recruiting partners in one of the areas chosen to pilot seven day access.
A three-month consultation period on the closure of the Kington Medical Practice’s rural branch surgeries in Eardisley and Pembridge, Herefordshire, will soon come to an end, with both surgeries expected to close due to a lack of GPs and problems with access.
The closures have prompted GP leaders in Herefordshire to start making plans for a further dip in their numbers, as the county braces itself for an anticipated spate of retirements.
Herefordshire CCG has announced that it is drawing up plans to assess the scale of the problem, starting with a ‘workforce plan’ that will provide a detailed profile of local practices.
This comes at a time when the GP federation covering the whole county is taking on extra work through its scheme to provide extended hours as part of the Prime Minister’s £50m ‘Challenge Fund’.
Grassroots GP leaders have said that it ‘grossly unrealistic’ for the Government to continue pushing extended hours access when so many practices are struggling to provide in-hours access.
Although exact figures are not known, the CCG says that the retirement rate is ‘slightly higher’ than the average and has acknowledged the region’s shortage of GP trainees, with dwindling numbers of younger doctors available to step up and take over partnerships.
Dr Andy Watt, chair of NHS Herefordshire CCG, said: ‘GP recruitment is a huge issue in Herefordshire, as it is nationally. As commissioners we are acutely aware of the shortage of trainees available to fill vacancies in our practices here and while we don’t know the number of GPs that might retire in the county in the near future, we anticipate a very similar picture to that which is faced nationally, if not slightly higher.
‘Herefordshire CCG is looking to develop a workforce plan, starting with a profile of local practices to get a better picture of our local GP population. Alongside that work we are looking to recruit more nurse practitioners and GP assistants to help alleviate the pressures.’
Dr Richard Dales, secretary of Herefordshire LMC, told Pulse that the situation in Herefordshire reflected the national GP recruitment crisis. He said: ‘I don’t think we’re that much different from anywhere else – I know there are a number of places, specifically rural areas, that are affected by a shortage of doctors coming through.’
He added: ‘We’re looking at new initiatives with the area team, looking at returners and so on to see if we can’t rustle up some more GPs. But I think we need to look to NHS England for advice – it needs to be some sort of national solution, and I suspect this really goes all the way up to Mr Hunt.’
Meanwhile, Taurus Healthcare – the provider arm of Herefordshire’s GP federation, to which all 24 practices in the county belong – is said to have received a ‘small number of quality applications’ for GP positions assisting with the county’s seven day access scheme and other roles paid for by the PM’s Challenge Fund.
Dr Dales, a non-executive member of Taurus Healthcare, said that a number of doctors, both local to Herefordshire and from further afield, had ‘stepped up’ for the extra shifts. He said: ‘There’s a great good will to help the federation in Herefordshire, and [Taurus’s] terms and conditions are fair – that’s why we’ve got people.’
But Dr Peter Swinyard, chair of the Family Doctor Association and a GP in Swindon, said this case highlights the difficulties with the extended access policy.
He said: ‘It’s totally and grossly unrealistic, with the present workforce struggling to provide an 8am to 6pm service five days a week, plus out of hours, 24/7, to expect them to take on extended hours as well. It is ridiculous to try and extend opening hour at a time when we have a workforce crisis. It lacks all validity.’
Although Dr Dales declined to comment on the amount paid to GPs in Herefordshire for their assistance with seven day access, Pulse reported earlier this week that doctors in Slough, another Challenge Fund pilot area, were being paid £100 per hour to provide cover for extended hours.
GP leaders in Slough have warned that the competitive rates of pay offered by the pilot schemes may be to the detriment of existing services, including out of hours.