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GPs asked to take on violent patients as CCG shuts down SAS practice

GP practices in Stockton-on-Tees are being offered payment to take on violent patients from a specialist practice being shut down by the CCG.

NHS Hartlepool and Stockton-on-Tees CCG said this comes as it has ‘taken the decision to permanently close’ the Birchtree Practice the end of March ‘due to the very low numbers of patients remaining at the practice’.

The practice has 460 patients, out of which 42 are on the Special Allocation Scheme (SAS) for patients who have been removed from other practice lists due to violent behaviour.

Its patient list reduced in 2016, when the CCG took emergency measures to transfer the provision of substance misuse services from the Birchtree Practice to the charity Change Grow Live, the CCG said.

Since then, the Birchtree Practice has operated on a short-term emergency contract which is due to run out on 31 March.

The CCG had already started encouraging patients to register with a new practice, ‘with the intention that Birchtree would close at the end of the contract’, according to CCG chief officer Ali Wilson.
At present, the CCG is looking for another practice that will be able to offer care to patients on the SAS scheme.
In line with national regulations, the new provider will be offered an enhanced payment to be able to safely care for the patients on the scheme.
A CCG spokesperson said: ‘The SAS scheme is a Directed Enhanced Service, which is a national enhanced service commissioned by NHS England. As such, the scheme attracts an enhanced payment, above the payment for the provision of core general medical services.’

According to NHS England, comissioners of SAS services need to make sure both clinical and non-clinical staff are trained in basic safeguarding for children and vulnerable adults, among a series of measures to guarantee the practice provides a safe service.
BMA GPC chair Richard Vautrey said: ‘It is important to ensure those practices signing up to the enhanced service have the necessary skills and support to enable this challenging group of patients to get the appropriate service.’

The news comes as a change to the GP contractual regulations earlier this year made it easier for practices to refuse or remove violent patients.

Following the update, practices are able to refuse to register patients if they have a violent flag against their record and it also allows practices to remove ‘mistakenly registered’ violent patients under the normal procedures.

A version of this article was first published by Pulse’s sister title Management in Practice