Exclusive A Lake District GP practice which struggled under the weight of workload related to unregistered tourists has now decided to hand back its contract.
An MP had previously said that the Central Lakes Medical Group had lost more than £70,000 of its income from seeing up to 2,500 tourists not registered with the surgery.
However, it has now emerged that the practice had been receiving £73,000 annually in atypical funding, which local commissioners have pulled in favour of piloting a dedicated tourist service.
In June this year, NHS Morecambe CCG decided to reduce that funding to £588, according to a document seen by Pulse.
GP partners at the practice warned Lancashire and South Cumbria ICB – which took over commissioning last month – that this would make the practice unviable.
They jointly put forward an alternative proposal with another local organisation to keep it going for the sake of local patients, however the ICB rejected the plan at a meeting last Thursday.
In a message to patients posted on the practice website, GP partners Dr Paul Davies, Dr Kaye Ward and Dr Paula Cook said: ‘With much regret we must inform you that due to a number of factors outside the control of the partners, we have resigned our [GMS] contract, handing it back to Lancashire and South Cumbria [ICB].’
The ICB has now put the practice out to tender and appointed a caretaker to take over once its six-month notice period has concluded.
Speaking to Pulse, a spokesperson for the GP practice said the ICB’s decision had left it with ‘no option’ but to hand back its contract.
The spokesperson explained that Central Lakes Medical Group, covering an area of over 200 square miles in the Lake District, has an unusually low-weighted list which is 15% lower than the average Cumbrian rural practice.
It also does not receive funding from dispensing, because the large number of tourists makes it viable for pharmacies to exist in nearby rural villages.
The practice is often a walk-in centre for urgent treatment given that there are ‘no other local facilities’, and the travel times of getting to other services, the spokesperson explained.
Therefore, in 2018 – following the withdrawal of the minimum practice income guarantee (MPIG) – the CCG and NHS England provided the practice with atypical funding to ensure it was sustainable.
At the time, they said this would remain in place until alternative solutions were agreed, according to the practice.
However the spokesperson said not only was this not honoured, but the dedicated tourist service was designed without input from local GPs.
They said: ‘The design of the pilot did not involve input by practices or PCN. The only funding available to practices was to provide additional sessions specifically for tourists which needed to be booked via the triage service.’
‘The practice would no longer control the triage of tourist access to its service.’
As a result of the reduced funding, the GP practice would have had to try to earn the money by doing extra work and incurring additional cost.
The practice spokesperson said: ‘That is not a viable solution for a small practice and continued uncertainty meant it was left with no option.’
Handing back the contract was ‘not the [GP partners’] preferred route and any new incoming organisation will struggle with the funding on offer to provide the services needed in the area,’ they added.
‘Funding is needed for services for residents, not just tourists. The cost to the NHS of pursuing the option of going out to tender is likely to exceed the cost of what was needed to support the practice to remain viable as a GP-led partnership.’
The Central Lakes Medical Group consists of Ambleside Health Centre and the Hawkshead Medical Practice – the latter of which Pulse has followed over the course of MPIG losses. In 2017, patients raised £30,000 in a bid to try to keep their local surgery.
Dr Peter Gregory, associate medical director for NHS Lancashire and South Cumbria ICB, told Pulse that the ICB is ‘working with a number of primary care networks across the Morecambe Bay area to develop services to support their patients’.
‘GP practices that share local geographies and similar patient populations work together to identify and implement services which support GP practice resilience and offer benefits for both registered patients and those visiting the local areas.
‘The Grange and Lakes PCN have an allocated budget which exceeds previous investments in the area.’
The ICB also said it is working with the practice to ensure a smooth handover of services, with a caretaker provider to run the practice from January until March next year, by which time a new GP provider will be confirmed.
‘The ICB is committed to ensuring that all patients within Lancashire and South Cumbria continue to have access to high quality general practice services,’ an ICB spokesperson said.