Hebden Bridge Group Practice to explain itself at Town Council meeting

Tony Martin, the Practice Manager at Hebden Bridge Group Practice, is attending the Hebden Royd Town Council meeting on Weds 25th September at 7.30pm to answer questions from Councillors about widespread public dissatisfaction with the Practice.

The Practice Manager is to give a 15 minute presentation responding to Councillors’ written questions sent to him in advance, and there will then be a 15 minute follow-up Q&A with Councillors.

The public will not be allowed to make statements or ask questions and the Town Council say they hope not too many members of the public will turn up.

At their 12th June 2019 meeting, all Hebden Royd Town Councillors expressed concerns about the NHS at national and local levels

This was in response to a request by Jenny Shepherd for Town Councillors’ help to ensure appropriate NHS care is available for local people.

Summing up the Councillors’ discussion, the Mayor (Cllr Carol Stowe) said it was probably up to them to voice the concerns of local people. The way forward was to facilitate a fairly rapid public discussion. They have rooms available in the Town Hall. Hebden Royd Town Council would invite local residents to air concerns, but make it clear the Council doesn’t have any formal powers.

However the 12th June minutes (item 72) do not record this decision.

The Town Clerk, Jason Boom, explained that after making this decision, Councillors started wondering if Hebden Royd Group Practice would be willing to attend a public meeting and felt that they wouldn’t. So although there was no decision to abandon the idea of a public meeting, instead the idea was floated of asking the Practice Manager for a briefing first.

As they’d already decided at their May 22nd meeting.

Better late than never.

The NHS as Bevan intended – public, based on meeting everyone’s clinical needs, free at the point of use – is under attack from years of government austerity lies, chronic underfunding, privatisation and the attempt to turn it into a business not a service.

We’re not going to let it go.

Let’s see what Hebden Bridge Group Practice tells the Council on Wednesday

As well as Tony Martin, the Practice Manager, I think Dr Nigel Taylor may also be attending the meeting.

He is the Practice rep on the Calderdale Clinical Commissioning Group Governing Body, which is responsible for planning and buying NHS services in Calderdale. Dr Nigel Taylor is also the Clinical Director of the new Upper Calder Valley Primary Care Network that covers Hebden Royd and Todmorden.

Primary Care Networks have been rushed in through a new GP contract that kicked in on 1 July 2019.

The Institute of Healthcare Management calls this a once in a lifetime monumental shift in GP practices.

Primary Care Networks are intended to:

  • Shift a lot of hospital services into the “community”, where much care will have to be provided by family, friends, voluntary organisations and the patient themselves who will be “empowered” to self-care. (They call this both the “left shift” and “the end of the dependency model of health care” – which is pretty rude to patients who rely on it.)
  • Financially incentivise GP practices to segment patients into cohorts, targetting high cost-patients most at risk of unplanned hospital admission and then fitting them with wearable apps and other forms of digital surveillance to monitor their health to try and keep them out of hospital.
  • Use a combination of patient data analytics and large scale behaviour change schemes to target patients suffering from modern epidemics like obesity, heart disease, respiratory disease, diabetes etc and make them shape up.
  • Replace many GPs with new grades of less skilled and qualified “allied health professionals and use social prescribing to direct patients to healthy community activities
  • Further restrict patients’ access to planned operations.

Hospital bed cuts on hold until Commissioners can show this new out-of-hospital system works

There are 14 new Primary Care Networks in Calderdale and Kirklees

Until the Clinical Commissioning Group can show this new system of out-of-hospital services is working safely, they are not allowed to cut hospital beds.

Cutting hospital beds is part of the proposal to turn Calderdale Royal Hospital into an acute and emergency hospital service for the entire population of both Calderdale and Greater Huddersfield, while turning Huddersfield Royal Infirmary into a small planned care clinic for all patients for both areas (except for high risk patients who will have planned care operations at Halifax.)

After the Secretary of State found that the original hospital cuts and centralisation proposal was not in the interests of the Calderdale and Huddersfield public, the hospitals trust is having to produce a revised strategic outline case.

Questions we’ve emailed to the Hebden Bridge Practice Manager

A year ago Tony Martin explained why they ended same day appointments and phone calls and replaced them with the Mytholmroyd walk in centre

The problems people were experiencing than haven’t gone away.

Patients’ current issues with Hebden Bridge Group Practice include:

  • Waiting outside Mytholmroyd walk in clinic in the rain and cold for 30 minutes with poorly children,
  • 2-3 hour waits at the crowded walk in clinic, often sitting on the floor
  • Being unable to get a follow-up GP appointment following hospital discharge,
  • Having to wait 4 weeks for a non-urgent appointment,
  • No continuity of care with a known GP,
  • Being physically unable to attend the walk in clinic and so going without any care,
  • Not understanding why the Hebden Bridge surgery is like the Marie Celeste and fearing it’s being deliberately run down
  • A breakdown in care for some patients with long term illnesses who can’t attend the walk in as their needs are not deemed to be urgent and can’t any longer get phone consultations when their illness flares up
  • Having to explain their illness in public to a receptionist with no medical training
  • Giving up on the practice

The list goes on….

As the public are not allowed to speak at the Council meeting on 25th September, we’ve emailed Tony Martin some questions.

Anyone is welcome to add their own questions in the comments box at the end of this blog post and we’ll add them to the list we’ve sent him:

  1. In September 2018 you reassured a patient that “there is no change to the arrangement that allows for patients with chronic conditions to ring reception to speak to a GP to have their symptoms recorded or have their medication adjusted, as a part of their care plan.” However, by December 2018, patients were reporting that the Practice was not honouring that commitment. Please will you explain?
  2. Patients have reported finding themselves in a consultation at the Mytholmroyd Walk in clinic with a Community Pharmacist who seems to struggle to follow a diagnostic questions checklist and to be well out of their depth in terms of reaching a diagnosis and appropriate treatment. Please comment.
  3. Now that patients who need an urgent appointment are expected to go to the walk in centre, is it still possible for patients with long term conditions who have flare ups to call the Practice directly without having to call NHS 111 or go to the Mytholmroyd walk in centre? (In August 2017 the Practice Manager confirmed in a letter to Upper Calder Valley Plain Speaker that they had removed the need for these patients to call NHS 111. Patients told UCV Plain speaker that this had made things much better for them. But comments since then on facebook seem to show things have deteriorated for these patients.)
  4. How has the roll out of NHS111 urgent care access in April affected patients’ access to HB Group Practice consultations? Who is responsible for the period between patients phoning 111 and any face to face assessment? Who is responsible, if triage / self care advice or signposting proves insufficient or inaccurate?
  5. From October 2019 onwards NHS 111 will be able to refer patients requiring minor/ lower acuity advice and treatment to community pharmacy. What arrangements if any has Hebden Royd Group Practice made for this change?
  6. What further changes are likely to patients’ ability to access face to face GP consultations, once the ‘digital by default’ processes for getting advice from GPs online, by skype and by apps are in place. And what is the time scale for this?
  7. GP referrals to Calderdale and Huddersfield hospitals – are Hebden Bridge GPs able to book these hospitals’ services including 2 week cancer referrals, or do GPs’ referrals go to ‘defer to provider’? We have heard from GPs in other practices that there is no visible appointment on Choose and Book, meaning the hospitals are in charge of booking, not the patient or GP. People then face a wait to be contacted by the hospital and offered an appointment in 6/12 months. This is leading to lots of self-funding private treatment, including by Hebden Royd patients if they are able to afford to pay. Once-accessible services like cardiology, respiratory, gastro now have 6 month waits. Please comment.
  8. Effect of Primary Care Network contract on continuity of care – the Primary Care Network contract seems to require GPs to limit their consultations to patients with complex needs, and for new grades of allied health professionals to see the rest. Is this the case in Hebden Bridge Group Practice? What are the Practice plans to employ new grades of allied health professionals? How will the Primary Care Network contract affect continuity of care?
  9. Are Calderdale and Huddersfield hospitals able to access GP patient records? Dr Nigel Taylor has told me the hospital staff were unable to access GP patient records because they’d not been trained in how to do this. Has this problem been solved yet?
  10. Ditto Yorkshire Ambulance Service paramedics – can they access patient records when they follow the Hear, See and Treat model and treat patients without taking them to A&E? We have heard of a Hebden Bridge patient who’s been treated inappropriately by paramedics because they’ve not been able to access patients’ records and so have not known what the patients’ problem is or what treatment they receive routinely and when their condition flares up, and have not believed patients when they’ve told them. Please comment.
  11. Calderdale Councillors Steve Sweeney and Jane Scullion have been assigned as Councillor members of the Upper Calder Valley Primary Care Network Board. What is their role? And are the Primary Care Network Board meetings open to the public? Are their agendas, minutes and papers published? If so, where? If not, why not?

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