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GP practice facing closure rescued by £100k bailout from NHS England

A Bristol practice has received a £100,000 bailout from NHS England after the departure of its two partners left it struggling to survive, Pulse has learned.

St Martin’s Surgery in Knowles, which was facing closure after Dr Holly Hardy and Dr Karen Houghton were forced to resign their contracts as a result of the recruitment crisis, was awarded £101,075 for locum cover between February and July this year.

The funding, from Bristol, North Somerset, Somerset and South Gloucestershire area team, was initially to support the practice as it underwent a merger, and when this fell through, locum support continued while the area team tendered for an interim provider.

It comes as a Pulse investigation reveals that around £220,000 has been made available across 18 practices in the rest of the country since April last year, with some areas offering management support instead.

According to figures obtained by Pulse under the Freedom of Information Act, 11 area teams have made some support available to practices, including assistance in conducting management audits and reviewing appointment process, while six area teams have offered financial support directly to practices.

Other examples of emergency funding revealed in Pulse’s investigation are:

  • Shropshire and Staffordshire area team has made £24,000 available to six practices since April 2014 – the same as it’s spend in 2013/14 – and has approved £63,000 in funding for a further six practices. The area team said it was used for location costs for newly recruited GPs, to train practice nurses returning to practice or moving from acute/mental health/community services into practice nursing, for GP returner and induction programmes and for enhanced training of pharmacists (e.g. independent prescribing qualifications) to allow them to take on certain tasks traditionally carried out by GPs.
  • Frinton-on-Sea, Essex, – where Pulse has previously reported the area team stepping in when  recruitment issues meant there were 8,000 residents to one GP – £15,840 was given to a practice to implement an ‘action plan’ which included reviewing the appointment system and employing a pharmacist to cope with demand.
  • Surrey and Sussex – £51,000 allocated across three practices in Hastings, East Sussex, where it was used directly for recruiting additional GPs

GP leaders said the funding shows NHS England has the ability to support struggling practices but have called for the scheme be broadened to ensure ‘transparency’ and ‘equity’ in distributing funds.

Pulse has been campaiging for NHS England to make emergency funding available to support struggling practices as part of its ‘Stop Practice Closures’ campaign. And, earlier this month, reported that GPs were being offered £20,000 ‘golden hellos’ to move to Leicester, as part of a £250,000 fund set up by NHS Midlands and East in the hope of attracting 12 new GPs to the city.

Dr Hardy told Pulse this week that she was still working at St Martins, as a salaried GP, after the surgery was taken over by a larger surgery in south Gloucester, which is initially running the contract on a twelve month basis.

She said: ‘At the time, we were paying the locums a lot more than we were drawing as partners, we were going into a negative situation and if we were going to merge or be taken over we needed to remain viable.’

‘Initially they [NHS England] did say to us they had no money at all. And I don’t know where that funding came from but they did manage to support us, and in doing that they did keep the practice going’

She added: ‘I think ideally, the area teams would be looking at a solution around where the doctors are going to come from, rather than putting money into practices that are struggling.’

‘But I guess, at that time they have to make the best choice as to what they think they should do, and I’m very grateful that they did keep us going in that sense.’

Dr Peter Swinyard, chair of the Family Doctors Association and a GP in Swindon – in the same patch where the area team awarded £30,000 to a Wiltshire practice struggling with recruitment – explained that demand for locums was especially high.

He told Pulse: ‘I’ve never done locuming in general practice – but one agency rang me and said there were seven practices in Swindon looking for a locum this week.’

He added: ‘It would be nice if all practices had a chance to ask for money, if there were money around to support practices in difficulties.’

‘And I think there has to be a bit more transparency, and a bit more equity about what’s going on. I don’t in any way mind NHS England supporting practice financially, and clearly it’s in patient’s interests to have a doctor available to them.’

‘If that’s the only way to do it, then get on and do it, but they’ve got to mend the broken boat at some stage, rather keep on bailing it out.’

GPC deputy chair Dr Richard Vautrey told Pulse: ‘It’s good news that some area teams have provided support to a some practices facing particularly difficult recruitment problems, and this has made the difference as to whether a practice stays open or closes.

‘However taken together the amounts are small and only support a tiny number of practices when many are facing real and significant challenges.

‘I hope that NHS England would ensure that all area teams take the lead from the best and that they step up their support for practices in crisis.’

An NHS England spokesperson told Pulse: ‘In exceptional circumstances, NHS England has the option to give financial assistance to any provider of primary medical services. There is no national criteria that governs this spend,  as each situation is different.  Area teams will make decisions on a case by case basis.’