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GP commissioning leader’s practice deregistered elderly patients for ‘financial reasons’

A PMS practice formerly run by NAPC chair Dr Charles Alessi has been rapped by NHS managers after an investigation into its decision to de-register 48 elderly patients from a care home last July found the practice in breach of contract.

An investigation into the decision by the Churchill Medical Centre in Kingston, where Dr Alessi was a partner for 26 years until this February, said the practice claimed it had been forced to drop the patients for safety reasons after its PMS funding was cut.

But the review by NHS South West London, carried out after LMC leaders reported concerns from other local GPs about the decision, rejected the practice’s claims, and said the decision to remove the patients from Kingston Care Home was for ‘financial reasons’.

It concluded that the practice was in breach of its contract, citing inadequate grounds for removal and a failure to warn patients as evidence.

The PCT said the breach notice allowed it to force the practice to accept the patients back onto its patient list, but said it would not ask them to do this, as ‘this would only cause further disruption to the care of a vulnerable group of patients’.

The review, released under the Freedom of Information Act to the Surrey Comet, warned a repeat of the breach could see the PCT terminate the practice’s contract.

In a letter to the practice informing it of the decision, the PCT said: ‘In your letter to Kingston Care Home dated 21 June 2011, you gave as the reason for the de-registration of their patients the funding constraints of your practice.

‘It is evident therefore that your practice has removed the Kingston Care Home patients from its list for financial reasons. This is not reasonable grounds for wishing to remove the patients from your list.’

In a statement released in response to the review, the Churchill Medical Centre said it was ‘disappointed with the conclusions’ but added: ‘We are confident lessons have been learned by all parties.’

‘These events took place after a protracted and polarised contractual dispute between the practice and the PCT, and at a time of transition from PCT to [cluster]. The practice believes these were significant contributory factors to the events as they unfolded.’

But in a letter to the PCT, Dr Julius Parker, the chief executive of Surrey and Sussex LMCs who raised the concerns on behalf of five other local practices, wrote: ‘I completely share your view patient care must not become a pawn in these processes.

‘Nonetheless, I am uncertain if the current outcome will seem satisfactory to those colleagues who first raised this issue with me.’

Dr Alessi declined to comment on the case directly, but told Pulse: ‘I stopped being a partner there earlier this year.’