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GP leaders issue guidance amid a flurry of practice closures



GP leaders in Wales have set out to help practices finding themselves with ‘no way out’, amid a raft of new closures.

GPC Wales chair Dr Charlotte Jones told Pulse that they will release guidance focusing on proactive measures practices can take to avoid ending up in the situation.

She said this comes as an increasing number of practices found themselves with no other option but to hand back their contract to the health board.

This includes the two-partner Borras Park Surgery in Wrexham, which will end its contract in September, leaving the health board in a position of having to reassign patients to other practices.

It also comes as the Coelbren Surgery, a branch practice in Powys, closed its doors 1 May, with patients moving to the main practice three miles away.

Abertawe Bro Morgannwg University Health Board said the decision to close came after a year spent trying to recruit new GPs.

It has tried a range of measures to try to keep both surgeries open, including expanding the number of patient consultations dealth with by phone, but said that with just two GPs for 6,000 patients it had become impossible to continue.

And last month, patients at one health board run practice in Rhondda which closed temporarily due to staff shortages were redirected to the main branch practice only to find no appointments available.

Dr Jones said the situation had left the GPC ‘extremely concerned’, adding that it wants practices to prepare for the worst at an earlier stage so steps can be taken to keep practices going, including working at scale with neighbouring surgeries.

And she said some health boards needed to do more to help struggling practices.

She told Pulse: ‘Whilst this problem is not unique to Wales, it is reflective of the pressures facing practices.

‘Any practice can find itself in difficulties through unfortunate and unexpected events and it’s vital that support is available to them.’

Guidance which has been developed for practices and will be published soon includes recommendations to seek LMC support at an early stage.

Dr Jones also said they had worked with the Welsh government to implement a series of measures to protect practices.

She said: ‘These include the Sustainability Framework, contract changes – in particular QOF amendments, reduction of last man standing and initiatives to address workforce issues – but for some practices, it is not enough.

‘This, coupled with years of underinvestment, rising workload demand and recruitment challenges in many parts of Wales, has led to a perfect storm, with some practices seeing no other way out than to hand back their contract,’ she said.

The GPC hopes that contract agreements around supporting practices to carry out practice development plans and the sustainability framework will help practices so consider their ‘resilience’ at an early stage, Dr Jones said.

‘However, we urgently need additional resources brought into practices that mirror those provided to directly managed practices, along with financial resources to support them,’ she added.

Welsh LMCs had previously said that around 18 practices in Wales submitted ‘sustainability applications’ for extra support from health boards in the year up to October 2016 – but that many more were at risk.