Posts Tagged “practice closures”
The Chief Executive of NHS England has said that 7 day access is needed to reduce health inequalities as the current system discriminates against low-paid workers who cannot get time off for mid-week appointments without losing pay. Meanwhile GPC Chair Dr Chaand Nagpaul has said he is happy to discuss extending access as part of GP contract negotiations but will not agree to 7 day access. Conservative MP and former GP Dr Sarah Wollaston has said that 7 day access is ‘completely unrealistic’ whilst the RCGP has claimed that 7 day access could cost £1bn a year.
Physician Associate trainees will be guaranteed jobs at the end of their training under a trial proposed for mid-Wales. Official figures have revealed that Salaried GPs earn less than 10% more than Physican Associates with GPs earning on average £54,600 a year versus £50,000 for Physician Associates with two or more years experience. Labour MSP, Elaine Murray has said that scientists should be able to retrain as GPs via shortcut courses to help ease the GP recruitment crisis.
Figures have shown that practices’ use of Locum GPs has increased by nearly 20% over the last year with many GPs choosing to work as ‘career locums’ or supplementing their income via locuming.
The RCGP has called for A&E funding to be redirected to General Practice whilst 5 practices at risk of closure are looking to merge with local hospitals to secure their future. Practices in Wales are able to apply for support from the Welsh Government under a new scheme to help vulnerable practices at risk of closure. Meanwhile, practices in the south-west can access a sustainability assessment developed by the regional team to help them look at ways to increase efficiency and succession planning.
The Family Doctor Association (FDA) has found that indemnity fees for GPs have increased by a quarter in one year. The BMA has hosted a summit to discuss the issue with NHS England making it a priority.
Another super-sized practice is set to be created in the East Midlands when 4 local practices merge with an existing large practice in the new year. The resulting practice will have a patient list of 100,000 cared for by 62 partners. The practice has further expansion plans to eventually care for around 300,000 patients.
NICE has warned that GPs are issuing 10million unnecessary prescriptions for antibiotics each year, experts have called for the most persistent offenders to be referred to the GMC.
A pilot scheme in Wales has saved over 500 GP consultations in a month one region by allowing pharmacists to supply medicines for common ailments for free. Patients can obtain free medication for problems such as constipation, dyspepsia, coughs and sore throats in the trial which has been running since 2013.
The National Association of Primary Care (NAPC) has called for GP and community pharmacy contracts to be ‘aligned’ by NHS England in order to relieve the burden on GPs. Meanwhile, the GPC has advised GPs not to sign the new ‘simple’ GP contract issued by NHS England as the wording prevents practices from taking legal action against their local area team.
GP OOH providers are struggling to fill their rotas as the weekend GP access schemes set up to relieve winter demand have continued. Whilst a survey has found that almost 80% of OOH GPs were limiting their shifts owing to the rising cost of indemnity.
NHS Lothian is considering allocating £1m in emergency funding as it has emerged that 1 in 6 practices have closed their lists. Whilst a survery has found that 15% of practices are planning to close their lists within 6 months, and 21% are considering mergers. In Northern Ireland, the GPC is setting up a ‘rescue’ service to support as many as 1 in 14 practices at risk of closure this year. A practice in Wales with 2,500 patients is set to close in October after no applicants applied to take on the single-handed practice which has been staffed by locums and supported by the Abertawe Bro Morgannwg University health board since the previous GP retired.
In the West Midlands, a group of practices are merging to form one of the largest GP partnerships in the NHS with as many as 180 partners. Our Health Partnership will be led by a Chief Executive and financial and operations officers elected by an elected board.
A BBC documentary, The Real Peak Practice, will air in September featuring the Baslow Health Centre in the Peak District. The programme aims to show the problems facing GP practices including recruitment and caring for elderly patients.
The RCGP has highlighted the pressure of GPs’ workload causing burnout and fatigue and endangering patient safety. Whilst a review of GP workload by Health Education England has recommended pilot schemes to test the effectiveness of a wider range of practice staff including medical assistants and paramedics. NHS England has announced new pilots in eight ‘vanguard’ areas which will see GPs working in A&E and OOH services integrated with ambulance services and NHS 111. The chair of the primary care workforce review has revealed that he was told to ignore GP staffing levels, as the Government claimed it was not required.
A survey of GP Partners has found that 62% of all GPs have taken a pay cut with an average reduction of 5.7%. Whilst the cost of 7 day opening for GP surgeries could cost the NHS £3bn a year, according to calculations by Dr Mortons’, a medical helpline which launched this month.
The GPC has called on NHS England to set up a financial resource for struggling practices in danger of closure. A group of practices in Staffordshire have raised fears of closure after finding that a change in management of their premises has left them with increased bills of up to 900%. A local area team has reviewed its policy of issuing breach notices to any practice that received an ‘inadequate’ rating from the CQC and denying support from the pilot programme run by NHS England and the RCGP.
A quarter of OOH shifts were unfilled in one area in Wales owing to a growing recruitment problem. This year, 85% of training places were filled in Wales after two rounds of recruitment and there will not be a third round.
Brunel Medical Practice in Torquay, Devon, has written to patients asking them to ‘bear with us’ as they struggle to recruit after a number of GPs retired. Meanwhile, St Luke’s Medical Centre in Gloucester has had to close after failing to replace the two partners who have been succession planning since August 2013.
Data from the GP Patient Survey has found that just over a quarter of patients in England were unable to see a GP or waited a week or more to see or speak to someone last time they tried. The survery comes amid news that a quarter of 7 day GP access pilots have cut their opening hours owing to lack of demand.
According to a survery carried out by Londonwide LMCs, 1 in ten London practices face closure within the next three years. Various factors were cited as reasons practices were considering closure, including workforce retirement and difficulties recruiting new staff. One GP explained the difficulties her practice faced and the reasons behind the decision she and her colleagues made to quit. Other GPs at the Limehouse Practice were visited by health minister Alisdair Burt, in a hastily arranged visit after reports that a proposed visit by Jeremy Hunt might not take place until after the practice is forced to close later this year. In Scotland, one area has warned that any unexpected illness or leave amongst GPs could lead to practice closures, as 11 full-time posts have been vacant for between three months and two years and a further 14 GPs plan to retire by December 2016.
The Head of NHS England, Simon Stevens, has annouced that the practice-list based model of general practice could be replaced in future. Another GP has suggested practices receive payments based on numbers of consultations in order to relieve the financial pressures they face.
It has transpired that the £7.5m promised by the Government to support community pharmacists will actually be used to give them access to summary care records – a policy originally announced in 2013. As part of the drive to recruit 1000 Physician Associates by 2020, the Government is considering granting them prescribing powers to relieve the pressure on GPs. The NHS is offering £15m to practices who take part in a pilot scheme to bring pharmacists into their surgeries.
In order to save money and reduce medicine wastage, from next year, all medication costing more than £20 will have the price printed on the label. Jeremy Hunt has also said that he supports the idea of charging patients for missed GP appointments and as a first step, patients will be informed how much their missed appointment has cost the NHS.
After two rounds of GP Recruitment earlier this year, official figures show that 20% of GP Training places remain unfilled with a third round to follow later in the year.
The Government’s flagship 7 day access policy is in the news once again with a mixed response as to its efficacy. Official evaluation showed that A&E admissions were reduced by 3% and said the scheme was set to be extended. However, CCG leaders in Yorkshire have scrapped the pilot scheme citing poor take-up of weekend appointments as one of the main reasons for abandoning the scheme. A joint report by the Patients Association and the Royal College of Emergency Medicine has found that same-day GP appointments do not stop patients from choosing to attend A&E instead. Meanwhile, according to research by the financial regulator for the NHS in England, a third of patients find it difficult to get an appointment. Although a smaller YouGov poll found apparent public support for 7 day access.
One of the biggest stories this month was Jeremy Hunt’s ‘New Deal’ for GP which has prompted a backlash from GPs and a petition with nearly 3000 signatures. Remarkably, Mr Hunt has also called for GPs to move away from the mentality of clocking off at 7pm.
Staffing in General Practice is still a cause for concern with promises of 5,000 more GPs and 5,000 support staff including 1,000 physician associates by 2020. Although the Government has since distanced itself from the pledge for 5,000 extra GPs. In Leicester, the CCG is spending £600,000 to bring over 10 US-trained Physician Associates to work in local practices. Recruiters have said more foreign GPs are essential in order to meet this target. Whilst regulations were changed this year to allow GP training applicants who failed the Stage 2 exam in the first round to re-apply in the second round. The Welsh Government is investing £34million into GP recruitment whilst the Scottish Government has announced that a new £50million fund for GP recruitment and retention is to be spread over 3 years, replacing a one year £40million fund.
Also in the news has been practice closures. One doctor explains why she and her colleague were forced to resign from their practice after a replacement for the retiring partners could not be found. A practice in Brighton was closed with no warning, following a CQC inspection, leaving nearly 10,000 patients to use local walk-in facilities. The entire patient list was subsequently transfered to one neighbouring practice. In Essex, a third sector provider has been commissioned by NHS ENgland to take on an APMS contract for 12 months after all partners at the GP practice resigned. Meanwhile a practice in London has been saved from closure by local campaigners who persuaded NHS England to use locums to keep the practice open whilst looking for a new provider to run the practice. Jeremy Hunt has agreed to shadow a GP at a practice in Tower Hamlets, but Limehouse Practice is facing a funding crisis and may close before he gets there.
The RCGP has called for an immediate halt to CQC inspections as it emerges that nearly half of GP practices spend more than 20 staff hours to prepare for them.
A pilot scheme in Glasgow is to offer 30 minute appointments to its most vulnerable patients with researchers from the University of Glasgow measuring the impact on hospital admissions.