Family doctors replaced by “supermarket” GP practices that see failing hospitals as a business opportunity

Shutting the stable door after they have let the horse bolt, Airedale, Wharfedale and Craven CCG advertise  that:

“Following the closure of Vale Street Surgery [in Keighley] we are keen to engage with anyone who may have been affected by this.
We are inviting people to attend one of the two events being held in December on:

  • Tuesday 6th December 10am-12pm at the Sangat Community Centre, BD21 3HU
  • Tuesday 13th December 6-8pm at Eastwood Community School, BD21 3JL.”

Although its satellite surgery in Vale Street closed after November 30, pressure on NHS England from a rammed public meeting in Keighley on 10th November means the closure of the vital  multilingual North Street GP surgery in Keighley has been avoided.

It continues to operate after its contract with Westcliffe Care UK expired at the end of November 2016, but Kathryn Hilliam, head of primary care co-commissioning at NHS England (West Yorkshire) told Bradford Telegraph and Argus that

“services at the Vale Street Surgery are unfortunately not sustainable for any service provider to deliver.”

Judith Joy, a Grassington resident who attended the public meeting to fight NHS England’s proposal to close North Street surgery, said:

“It seems to me since the Minimum Practice Income Guarantee was withdrawn, profits not people are the bottom line for NHS England. Our practice in Grassington is now an offshoot of Ilkley Moor after their merger and our lead GP is leaving.”

Privatisation doesn’t work

The threatened closure of both Vale Street and North Street GP surgeries arose as the service provider, Westcliffe Care UK, had a contract with NHS England to deliver GP services which was  due to end on November 30th.

Westcliffe Care UK had only taken North Street Surgery on for a 12-month contract, it had proved expensive to run, so they had given notice that they would not want to continue with the contract. But after the public meeting had aired all the issues, the Chair Kaneez Akthar, Keighley town councillor, got a support group going.

Judith Joy said:

“She was most effective holding NHS England representative, Brian Hughes, West Yorkshire Locality Director and David Black medical director of NHS England Yorkshire and Humber, on the platform, to account for the non-consultation – indeed secrecy and apparent preference (strenuously denied) for the immediate closure and dispersal of patients into other practices.

It is the Sustainability and Transformation Plan in practice, and saving money at all costs is the object.

We are fed up of these secret deals which see private health companies benefit at the cost of the patients who pay for our NHS.”

Before Westcliffe Care took on the North Street GP practice, the previous provider One Medical Group  – formerly known as One Medicare  ran it for 5 years leaving a debt of £250,000.”

Under One Medicare the North Street practice had the lowest ranking in the AWC CCG area, with a patient satisfaction rate of just 40 per cent.

One Medical Care  has recently handed back a GP contract in Bridlington , bringing GP services in the town to crisis point

Widespread GP underfunding and closures

Successive governments have been under-funding the NHS since 2010 and continue to do so.  If services were to continue at the current level, there would be an NHS funding shortfall of somewhere between  £22bn-£30bn by 2020/1. Within that underfunded NHS budget, the proportion going to GPs has fallen.

In March 2016, GP online reported that over 10% of the total number of PG practices in England, were identified by local NHS England teams as qualifying for support under a £10m ‘vulnerable practices’ fund pilot scheme.

NHS England plans to privatise family GP practices and hand them over to large companies

Brent Keep Our NHS Public in NW London are aghast at NHS England’s plans to privatise traditional GP practices in their borough and hand them over to large companies.

The NW London “Shaping a Healthier Future”  hospital reconfiguration – which has already closed Hammersmith and Central Middlesex A&Es – requires the transfer of hospital services into the community.

This creates an contracting opportunity that feeds the development of large scale GP “locality companies” and destroys GP practices that operate as family doctors.

The West Yorkshire & Harrogate Sustainability and Transformation Plan has similar goals.

On p11 the WY&H STP says that “common actions to drive impact in our plans” includes:

  • primary care at scale and new models of care in the community,
  • a new primary and community care compact with the voluntary and community sector,
  • commitment to implementing the General Practice and Mental Health Forward Views and
  • “managing demand for” (ie restricting access to) acute services.

On p 12, the WY&H STP says that primary and community services are one of the “priorities for working together at a West Yorkshire and Harrogate level” – ie across CCG/local authorities areas.

The Bradford District and Craven locality STP (part of the W.Yorks and Harrogate STP) announces the intention to carry out their primary care commissioning strategies    which include:

“transformational change – wider primary care at scale”.

This is unlikely to go down well with the public. At the Keighley public meeting to keep the North Street GP surgery open, one person spoke for all when they said:

” I don’t give a damn about your trial models,  I’m a patient here and demand my rights to a GP as I’ve had for 30 odd years”.

The Bradford District and Craven locality STP also aims to

“deliver population health outcomes through new contracting, payment and incentives in line with accountable care models  elsewhere.”

Who knows what this means?

Maybe it’s explained in the 5 year GP Forward View that NHS England published in April 2016 as part of its so-called Sustainability and Transformation Plan guidance. This pushes:

“Care Redesign” through “practical support for individual practices and for federations and super-partnerships; direct funding for improved in hours and out of hours access, including clinical hubs and reformed urgent care; and a new voluntary GP contract supporting integrated primary and community health services.

General practice in 2020 will not look the same.”

What it could well look like is this: privatised GP companies with  a huge  registered population, providing many services moved out of hospitals into the community – in the process destabilising the hospitals because they lose the income from those services.

Lo and behold: the CEO of the Lakeside Healthcare group of practices – one of the biggest GP partnerships in England – says he is ‘delighted’ to be surrounded by ‘failing hospitals’, because ‘in hospital failure, there exists opportunity’. For his company to buy failing hospitals.

For good measure,  the Lakeside Healthcare CEO Robert Harris is a former director of strategy at NHS England and investment banker.

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