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GPs apply to close surgery to save primary care from ‘collapse’

A GP practice in rural Wales has applied to close one of its surgeries to ensure patient safety and ‘prevent the complete long-term collapse of the area’s local primary care services’.

After a year of unanswered job adverts and difficulty attracting locum cover, Dyfi Valley Health said it ‘regrettably’ asked Powys health board for permission to close one of its two practices. It said this would help it to consolidate services, thereby preventing them from deteriorating further. 

Practice manager Lucy Cockram told Pulse they tried desperately to keep services going amidst staff shortages – including introducing a GP-led triage system – but they could no longer ensure safe services for patients.

The surgeries, which have a total of 6,700 patients, also applied to the health board for sustainability funding but were offered just half the requested amount – a decision they are now appealing.

Ms Cockram said as a practice they had looked in detail at how they could survive and introduced new models of working but were been left with no choice.

She said: ‘Due to our location we have trouble attracting locums. Some only come by train so cannot drive out to our very remote Cemmaes Road site.

‘Locums can cancel at very last minute, the worst so far this year being 48 hours’ notice, so we are left with no GP and a full clinic.’

In a statement to patients, the practice wrote: ‘To maintain high levels of patient care, and to prevent the complete long-term collapse of the area’s local primary care services, Dyfi Valley Health has regrettably submitted an application to close the Cemmaes Road Surgery.

‘If the application to Powys Health Board is successful, Machynlleth Health Centre will consolidate these services thus ensuring that local primary care services are both improved and protected for the future.’

Mrs Cockram explained the three GP partners are ‘very committed’ to maintaining services in the area, and will carry out home visits, chair a virtual ward meeting daily with the district nursing team and remain involved with both local hospitals.

The Cemmaes Road Surgery GP partners had previously taken over Machynlleth Health Centre after its contract was handed back to the health board.

They took over the centre to stabilise their own practice – which had struggled to cope with an influx of patients due to the changes at the health centre – and ensure continuity of care for patients, with support from the health board.

The partners told Pulse that if they are now not given permission to consolidate the two services on a single site, then there is a real risk of burnout among GPs.

‘The domino effect would involve neighbouring surgeries having to extend their practice areas to take on our patients if the services collapsed, putting massive additional pressure on five other surgeries, three of which are already struggling with their staffing,’ they said.

BMA Wales has long-warned of further practice closures with many practices on the brink of survival.

A spokesperson for Powys Teaching Health Board said: ‘The practice is finding that the situation is not sustainable and have asked that further steps be taken to prevent local services from collapsing completely.’

‘Part of our role as a health board is to consider this request carefully, and to identify what options might be available,’ they added.

The health board will now write to all patients registered with the practice to outline the challenges being faced, the potential options and to seek views.

Last September, the RCGP warned over 750 practices could close within the next five years because they are relying on GPs approaching retirement.