Health chiefs have written to patients at five doctors’ surgeries across Brighton and Hove after the company that owns them said that it was quitting.
NHS bosses hope to reassure people as they work out how to ensure that about 11,500 patients still have a doctor when the Practice Group pulls out of the area.
The company has given notice that from June it will no longer run
- The Practice Whitehawk Road, at the Wellsbourne Health Centre, which has about 3,969 patients, some of whom registered there after the closure of Eaton Place Surgery in Kemp Town last year
- The Practice Hangleton Manor, in Northease Drive, Hove, which was recently placed into special measures and has about 1,986 patients
- The Practice North Street, based in Boots, North Street, Brighton, which has about 2,134 patients
- The Practice Willow House, in Heath Hill Avenue, Lower Bevendean, which has about 1,977 patients
- Brighton Homeless Healthcare, Morley Street, Brighton, which has about 1,354 patients
A letter from NHS England to patients said: “We may need to ask you to register with a new GP practice in order to make sure you can continue to get medical care when you need it but no decisions have yet been made about this.
“You will be given as much notice and support as possible to register at a new GP practice if this is the case.”
The letter also said: “Please note that you do not have to take any action at this point.”
NHS England said: “Our priority is to ensure all affected patients have ongoing access to local GP services following notice given by the Practice Group that they wish to stop providing services at five local surgeries in Brighton and Hove.
“We have written to patients to reassure them that we are working to secure alternative arrangements for their care and are continuing to work with NHS Brighton and Hove Clinical Commissioning Group (CCG) to identify the available options.
“All patient feedback will be taken into account in reaching a final decision about how to guarantee their future care and we will update patients about this as soon as we can.”
The options include asking the Practice Group to change its mind or to keep running the surgeries for a few months longer until a new provider can be found.
A proper procurement process could take up to nine months, according to NHS England, although it may be possible to offer a short-term contract for an interim period.
When Goodwood Court closed – in Hove last year – a temporary contract was handed to the nearby Charter Medical Centre.
It runs out in a few months’ time, shortly before the contract for the Brighton Station Walk-in Centre also expires.
The Practice Group has a Personal Medical Services (PMS) contract worth £1.16 million a year to run the five surgeries.
It is estimated to receive a premium of about 20 per cent compared with the income of most GP (general practice) surgeries in Brighton and Hove.
The government has ordered a review of PMS contracts aimed at bringing down costs. The threatened loss of income – over four years – appears to be behind the decision to quit. Staff shortages haven’t helped. Nor has the prospect of the landlord converting Willow House into student flats or John Lewis taking over the Boots store in North Street, Brighton.
The Practice Group said: “Following NHS England’s recent PMS review of our practices in Brighton, it is with great regret and sadness that we have given NHS England notice to terminate the joint PMS contract in respect of the five Brighton-based GP surgeries where we currently deliver primary care services.
“These surgeries operate under a sole contract and therefore the Practice Group has no option (but) to exit all five.
“The Practice Group has a longstanding connection with Brighton and this decision has not been taken lightly.
“Over the last few years we have tried to develop different ways of working across the surgeries to improve the provision of services to our patients, many of whom come from the most deprived areas in Brighton including caring for the vulnerable homeless population of the city.
“As is the case across the country, there have been increasing pressures on general practice in Brighton, rising demand for services, difficulty recruiting and retaining GPs and rising costs with no matching increase in resource.
“These pressures fall harder on smaller practices and all of our practices in Brighton are smaller than the national average, four of them significantly so.
“Two of our surgery sites also face relocation because of landlords’ redevelopment schemes which has added additional pressure to the contract.
“Over the years we have made significant investments to support the surgeries with the hope that this would be a sustainable route to viability.
“However, the planned significant reduction in funding going forward that follows from the PMS reviews means that, in our view, it will be impossible to run these surgeries under present contractual arrangements.
“NHS England has written to key local stakeholders and all affected patients from each practice advising individuals of the situation and to provide them with an opportunity to give feedback around arrangements for their future care, including any specific concerns they may have and what their next steps should be.
“The Practice Group remains committed to our patients during this transitional time and will continue to work with NHS England South East Team and Brighton and Hove CCG to ensure a smooth handover of patient care.”
In a letter dated last Wednesday (13 January) Sarah Macdonald, director of commissioning for NHS England South (South East), said: “In response to the provider’s decision, NHS England is now working to identify alternative options to guarantee ongoing care for all affected patients before the current arrangements end.
“We are currently in discussions with the Practice Group to ensure that we have as much time as possible to agree continued patient care.
“We will update patients with further information as soon as we are in a position to do so but they do not need to take any action at this point and can continue to receive care at their surgery in the same way at the present time.
“We are working closely with NHS Brighton and Hove Clinical Commissioning Group (CCG) to ensure that we consider any options which will ensure the delivery of continued and sustainable local GP services to all those patients affected.
“This includes working to ensure the needs any vulnerable patients continue to be met, including those who are homeless and who currently use services provided by the Practice Group.
“We will be liaising with other local GP practices to determine their current individual capacity to register new patients as well as assessing whether there is the opportunity to take a different approach in order to support the best possible long-term care for affected patients.
“No decisions have yet been made about this. We need to identify and assess all available options but wanted to ensure patients and other members of the local community were informed straight away about these developments.”
“At a local level, NHS England and NHS Brighton and Hove CCG are continuing to work closely together to address these challenges and to ensure the ongoing development of sustainable local GP services.
“We will therefore need to consider how we can ensure the long-term sustainability of services that will meet the needs of all patients (including any vulnerable patients) in determining how to guarantee ongoing care for those currently cared for by the Practice Group.
“We appreciate that colleagues may be concerned about the provider’s decision to end current arrangements for the provision of services at these surgeries following the closure of Eaton Place Surgery and Goodwood Court Surgery last year.
“Please be assured that in responding to this development we will ensure patients can continue to access local GP services, as we have done previously.”
Brighton and Hove CCG chairman Xavier Nalletamby said: “While the CCG is not ultimately responsible for the Practice Group decision or for commissioning primary care in Brighton and Hove, we are actively engaging with all affected and neighbouring GP practices and with NHS England to support a calm, well thought through and fair process for local patients and general practice.
“We hope the outcome will strengthen and improve the quality of general practice in the city in the longer term and will be doing everything we can in the short term to help prevent practices from being destabilised or overwhelmed.”
Dr Nalletamby, a GP at St Peter’s Medical Centre, in Oxford Street, Brighton, added: “Final decisions on the future provision of services at the affected GP practices have not been made yet and it will take time for all available options to be identified and assessed.
“Patients registered at these practices do not need to take any action at this point and will continue to receive care at their surgery as normal.”
NHS England is in talks with the Practice Group. It should know within weeks what steps it will need to take next and how that will affect the five surgeries and their 11,500 patients.