Thursday, 21 March 2013

NHS report highlights lack of understanding

The below is a copy of a report submitted by the Commissioning team, to the CCG team, for their cluster meeting on 6 February.  It is full of inaccuracies, as usual, and highlights the team's complete lack of understanding of the impact the Centre and its closure will have on patients in and around Ilkeston...  Shame on you NHS Derbyshire for refusing to listen to your patients... again.

6th February 2013
Report Title: Ilkeston Family Practice and Walk in 

1. Background and context
Further to a number of papers presented at the Confidential Board, this paper provides confirmation of the closure of the Ilkeston Family Practice.

A five year APMS contract was awarded to Integral Healthcare Partnership in 2009 as part of the National Equitable Access Programme that required PCTs to establish services from 8am to 8pm daily. The service was to offer primary care medical services as a normal practice and to provide open access for registered patients, and a walk in service for non-registered patients, via an arranged appointment or on a “call in” basis.

The service did not develop as planned and the provider failed to meet the planned activity in both registered patients and open access contacts. Following discussions between the PCT and the Provider, it is clear that the service is not financially viable for the provider to continue until the originally agreed contract end date of 31st March 2014.

It has therefore been mutually agreed, that the contract should be terminated early, and the date agreed is 28 February 2013. Letters were sent to the registered population of the practice advising them of the closure and requesting that patients register with alternative GP Practices in the Ilkeston locality. The PCT is monitoring the numbers of patients leaving the practice and registering elsewhere. There are seven practices locally with open lists that will be able to receive the patients, including West Hallam Practice.

Following agreement to the termination date the PCT arranged two public events to explain to patients and other stakeholders about the plans for closure of the GP Practice and Walk in Centre element, and to advise of alternative local services for patients to access.

The public meetings were held on 18 December 2012, and 8 January 2013 where PCT commissioners, CCG representatives and PPI team met and explained the rationale behind the decision to close the services. In response to the challenge that no public consultation had taken place prior to the decision to close, the PCT has made it clear that this was not a planned change and was in response to an issue with the provider not meeting the planned activity for the contract.

2. Matters for consideration

It was clear from the public meetings that patients using this service objected to its closure, although commissioners were able to explain that any perceived impact upon access and urgent care would be mitigated by the alternative local services available including other GP Practices, MIU and NHS 111. In addition a pilot scheme led by the LAT & Erewash CCG to increase access during the winter period across GP Practices in Erewash has been agreed which will explore surgeries opening seven days per week for booked appointments. The pilot scheme will have the majority of practices participating, and it is planned to commence from 4 February 2013, for a period of 8 weeks. The outcomes expected will be a reduction in the use of MIU in Ilkeston and reduced use of A&E by enabling more patients to be seen locally within their own practice, offering more access and choice. It is anticipated that this proposal will support the needs of patients locally.

3. Assessing Equality Impact
• Better health outcomes for all:
Patients will be able to receive a wider choice of access to planned care with the majority of practices in the Ilkeston locality opening longer hours, and the availability of more clinical services will have a positive impact upon health outcomes.
• Improved patient access and experience:
The access for services should be easier and similar for all patients. The pilot scheme via Erewash CCG will help investigate how weekend services support patient care in primary care services and its effects across the community and its service provision. Significantly, access as well as giving patients a better experience overall for their healthcare needs is an essential part of the pilot.
• Empowered, engaged and well-supported staff:
The provider and commissioner mutual agreement to terminate the service was due to the financial non-viability of the service due to the provider being unable to attract the agreed planned activity within the contract schedule.

4. Actions and recommendations
The Board is requested to note The planned closure of services at Ilkeston Family Practice and Walk in Centre as from 28 February 2013. The pilot scheme for access being developed by Erewash CCG is planned to commence on 4 February 2013 to support access to primary care.

Keith Mann – Primary Care
Vikki Taylor – Commissioning Director
22 January 2013

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