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Hospital steps in after 27,000-patient practice closes

LMC leaders have convened an emergency meeting to prepare practices for a potential influx of new patients after a major GP group announced the closure of two of its branches and a take-over of three others by the local foundation trust.

As of Friday this week, the three of the five Derbyshire GP practices that comprise the Hollywell Medical Group will move under the control of Chesterfield Royal Hospital NHS Foundation Trust, while Holywell House and Barrow Hill surgeries will close tomorrow.

Staff and the group’s 27,000 patients were notified on Monday about the new arrangement, and existing patients were advised they can still be seen at any of the group’s remaining practices.

But Derbyshire LMC said they were concerned of the ‘domino effect’ the closures may have on neighbouring practices and have scheduled an emergency meeting tomorrow. The concern is that large groups of patients looking to register elsewhere may destabilise already over-stretched services.

According to LMC leaders, the group practice’s problems stemmed from long-term recruitment issues after the sudden departure of several GPs. As a result, the practice had been heavily dependent on locum cover, and the CCG and area team had exhausted other alternatives to keep the practice open, the LMC said.

Royal Chesterfield said it is ‘delighted’ to step in and it’s provider arm, Royal Primary Care will operate the services as an ‘emergency caretaker’ until 31 March 2016 while consultations get under way to find a future provider, potentially via a competitive tender. Meanwhile North Derbyshire CCG said that although unexpected, this was a ‘good opportunity’ to forge closer links between primary care and secondary care services in the area.

Derbyshire LMC secretary Dr John Grenville told Pulse: ‘Between now and [March 2016] there will be consultations about what to do next, and it may well go out tender.’

‘Following the announcement, the LMC’s main aim… is to ensure that there isn’t a domino effect, that patients don’t flee the practice that’s involved and start putting unmanageable pressure on practices.’

‘It is difficult to predict how many patients would want to register elsewhere, and we will be talking to the other practices about that and how they can react if they see large numbers of patients coming in and wanting to register with them. So we’ve got a meeting tomorrow.’

He added: ‘This is a reflection of recruitment and retention crisis in general practice, and it will not be the last practice.’

Pulse has already reported the case of Midlands GP and Pulse columnist Dr Hadrian Moss who attracted the ire of his area team after following LMC guidance which sets out process for GPs to refuse new patient registrations without the area team approving a list closure.

Gavin Boyle, chief executive at Chesterfield Royal Hospital NHS Foundation Trust, said: ‘We are delighted to step in to sustain these services for local people and we’re looking forward to bringing GP, primary care and hospital services together in ways that will benefit all our patients.’

Dr Ben Milton, chair of North Derbyshire CCG said: ‘The news that Holywell Medical Group would no longer be able to provide GP services was unexpected and we appreciate this may cause concern to patients.’

He added: ‘We believe that Royal Primary Care will be an excellent caretaker provider and see this as a good opportunity to forge stronger links between GP surgeries (primary care) and local hospitals (secondary care) and support the principle aim of our local 21st Century Joined Up Care programme which aims to bring services closer together’.

A recent analysis by Pulse found a 500% increase in the number of practices approaching their area teams for advice and support about practice closures this year, as well as increased in the number of surgeries handing back their contract.

Pulse is lobbying the government through its Stop Practice Closures campaign to make available emergency support for struggling practices, to provide ensure they do not have to close as a result of growing workload or workforce pressures.