Agenda item

This report is to inform the Committee of changes relating to Sterling House GP Surgery.  The surgery is managed by College Health Ltd and they have recently given notice on their GP contract.  The Committee have been invited by NHS England to comment on this issue.

Discussion:

With the permission of the Committee Councillor Osborne, as one of the ward Members connected with Sterling House GP surgery, introduced a number of questions and concerns about the proposals as follows:

·         According to NHS England the area warranted additional GP provision and was even subject to planning application for a Healthy Living Centre in 2011/12.  Where was the additional capacity?  Basis for this Healthy Living Centre was specifically to address capacity issues; we now have a suggestion to reduce capacity in situ

·         Waiting times in Boots Clinic are very high.  Where are we seeing patients transfer?

·         How was NHS England making decisions on clinics; clinical or financial pressures?

·         Had NHS England visited Churchill Clinic: were they aware of capacity constraints in terms of parking and accessibility?  It was situated near a main road with limited parking.

·         What was the longer term ambition for Luton Medical Centre.  Doctor present was managing another site and was part time?  Clinic facilities were limited.

·         Communications – has NHS England communicated with patients at the other clinics to understand feelings on capacity issue and potential for increased waiting times?

·         Longer term aspirations – area was seeing new residential development and had a high level of transience with buy-to-lets.  We may already be seeing under-registration in the Luton area leading to pressures on A&E services.  Was this acknowledged?

The Chairman offered the opportunity to the other ward Member, Councillor Franklin to speak.  He then queried how local patients of the surgery had been informed and what options had been open to them.

The Head of Primary Care, NHS England South, referred to a meeting which would take place on 14 August to determine the options for Sterling House, and to which representatives from the Committee had been invited, and set out the context in relation to Sterling House.  He stated that it was unfortunate it had not been possible to get the options paper made available for the

Committee.

In relation to the building at Sterling House it was clear that College Health had struggled, the site was on a semi industrial estate with limited car parking and had previously had a second practice, Malling Health on the same site.  The landlord now wished to sell the property.  The College Health practice has a total of 1,852 patients, a number of patients had recently moved to the Boots practice in Chatham but this meant that there were in excess of 6,000 patients at that practice.  He explained the difference with the contract that NHS England had with College Health which was an Alternative Provider Medical Services (APMS) contract which was for a fixed term period.  This differed from the normal GMC contract which was a contract in perpetuity.  APMS contracts do not offer the same flexibility and were only held by the original contract holder for a fixed period.  Now that College Health had terminated their contract it was up to NHS England to determine whether to disperse the list or to offer a new contract but with a small number of 1,852 patients this would be unlikely to be of interest to a new contractor.

In view of the fact that this termination of contract would not be an isolated case in Medway he felt it would be helpful if a discussion could take place with all Councillors in order to brief them on the many contractual issues facing NHS England.  Consideration was being given to the best way to organise future provision of primary care to meet the needs of Medway residents possibly using a hub and spoke model to allow greater flexibility across the service. The Chief Clinical Officer, NHS Medway CCG explained that in view of the fact the CCG were applying for full delegated powers the CCG would wish to be involved in any such discussion.

Concern was expressed about the ability of some of the local practices to cope with an influx of new patients.  The Head of Primary Care, NHS England South agreed to confirm, following the meeting, the actual number of GPs employed at Boots in Chatham.

He then explained that letters would go to all patients explaining the options, there would be registration events to assist patients in registering elsewhere and a helpline, with translation service, will be set up. 

A request was made for an update to the October meeting as well as an all Member briefing on the future of primary care in Medway.

Decision:

The Committee agreed that:

(a)  The Head of Primary Care, NHS England South would supply the Committee with further details in respect of the number of GPs employed at Boots surgery in Chatham;

(b)  An all Member briefing be arranged, as soon as possible, in order for NHS England South and NHS Medway CCG to set out the issues facing them in planning primary care services to meet the needs of Medway residents.