Archive for June, 2012

Are NHS walk-in centres on the way out?

Posted on June 29, 2012. Filed under: Closure, GP consortia, GP-led health centres |

By Brian WheelerPolitical reporter, BBC News | 28 June 2012

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Walk-in centres are rapidly becoming a casualty of the tougher financial climate in the NHS in England.

The centres – which treat minor ailments without an appointment – were a flagship policy of the previous Labour government.

They are popular with patients but critics say they’re not cost-effective.

Figures suggest a quarter have closed in the past year but the government say the services they offered have not been cut.

The centres were meant to relieve pressure on A&E departments by providing easy access to treatment for minor ailments.

The government says these services are still available when the centres are relocated to hospitals – but critics say patients have to join long queues at A&E or make an appointment rather than simply being able to walk in off the street and see a nurse or doctor.

The Department of Health says it does not have data on how many walk-in centres have been closed, but analysis of weekly NHS hospital activity statistics show there were 75 non-hospital providers of emergency care in June 2012, which could also include urgent care units.

That is 26 fewer than in the same month last year – a reduction of 25%.

‘Not being cut’

Health Minister Simon Burns said: “More people than ever are being treated in these units, almost 20,000 more compared to last year.

“Some of these services have recently been taken over by hospital trusts, whilst others have been integrated into local urgent care services, so while the number of organisations might appear to have fallen, this has not affected access to urgent care services, in fact people using them has increased.”

Labour MP Gloria De Piero, earlier this month asked Prime Minister David Cameron why the “popular” walk-in centre in her Ashfield constituency and “similar walk-in centres are closing all over the country”.

NHS Victoria walk-in centre
The Victoria walk in centre in London closed in December

Mr Cameron said it was “certainly not because the money in the NHS is being cut, because it is not being cut” but decisions need to be “taken locally” about how “money in the NHS is spent to deliver better health outcomes”.

The Department of Health said the Ashfield walk-in centre – one of two to be closed in Nottinghamshire – has been replaced by a 24-hour unit at the nearby King’s Mill hospital.

But – in a letter to Health Secretary Andrew Lansley – Ms De Piero says people in need of primary care services now “either have to first present themselves at A&E or make an appointment” and “no longer had the ability to walk-in directly”.

‘Successful’

Walk-in centres have been closing down across England for the past two years. Among those to go in recent weeks is a facility in Tooting, in South London, which has been incorporated into the A&E department at nearby St George’s hospital.

“The relocation next to the minor injuries section within A&E is designed to help deliver care to patients in the most appropriate place and improve patient experience,” the hospital said.

A privately-run centre in Victoria, central London closed its doors in December. It was commissioned by the Department of Health but when its five year contract ran out the local Primary Care Trust decided not to keep it open, to save money.

Walk-in centres were used by more than three million people last year and they “have proved to be a successful complementary service to traditional GP and A&E services”, according to the NHS Choices website.

But the Department of Health says they are not a “nationally mandated” policy and GP commissioning groups will be free to shut them down when they take over from Primary Care Trusts as part of the government’s NHS shake-up.

Critics of walk-in centres say they have failed to relieve pressure on A&E services in the way Labour planned and that the cost of treating each patient has gone up from an average of £36 in 2008-09 to £39 in 2010-11.

But patient groups say they remain highly popular with those that use them.

Katherine Murphy, chief executive of the Patients Association, said: “Despite the many promises of patients having choice within the NHS, this is yet another example of having those very choices removed in the name of efficiency savings.

“Walk-in-centres provide a vital function for those who are unable to access their GPs, due to excessive waits and those who do not want to bother the already heavily burdened A&E staff.

“Our helpline regularly hears from callers who have had a range of issues with GPs and hospitals, but we hear almost universally about just how popular walk-in-centres are.”

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Loophole in APMS contracts threatens primary care stability, enquiry warns

Posted on June 28, 2012. Filed under: Closure | Tags: , |

GP Online | By Marina Soteriou, 27 June 2012

A serious loophole in APMS contracts allows GP practices to become a ‘commodity traded in the private market’, an enquiry into the closure of a London practice run by a private company has found.

Camden Council’s Health Scrutiny Panel of Enquiry report into the closure of the Camden Road Surgery in north London, due to be discussed at a council meeting tonight, is urging the NHS Commissioning Board (NCB) to take ‘prompt action’ to prevent a repeat of the incident.

The panel hit out at private companies involved in running the surgery for failing to provide evidence to the enquiry, and called for greater transparency on deals with private firms involved in running NHS services.

Private healthcare firm United Health won a five-year contract to run the Camden Road Surgery in 2008, but then transferred the contract to another provider, The Practice plc, in April 2011.

A year later, in April 2012, the surgery was shut down when its premises lease ran out, forcing its 4,700 patients to register elsewhere.

The report reads: ‘There appears to be a serious loophole in the national contract for alternative providers, which allowed United Health to transfer the contract.

‘The panel were of the view that this was a serious loophole. In our view, primary care by GPs should not be a commodity traded in the private market and prompt action should be taken by the NHS Commissioning Board, which will be responsible for commissioning primary care, to remedy this.’

Minimise use of locums
The panel said it would welcome further discussions with NHS North Central London and with the NCB on how contract specifications can best ensure continuity of care and to minimise the use of locums.

Its report reads: ‘Contracts should promote the long-term commitment to continuity of GP care, to counter the concerns expressed in evidence that large private providers have less commitment to a local population.’

The enquiry said it welcomed the prospect that from next April councils’ health and scrutiny committees will have enhanced power to require private health providers and GP practices to go before them.

It said: ‘A regrettable aspect of this enquiry was the failure of United Health or The Practice to provide any evidence whatsoever.

‘We welcome the decision of the Information Commissioner’s Office to order Camden PCT to disclose details of the contract with United Health, including the pricing, and believe further consideration needs to be given by the NHS Commissioning Board to the transparency of contractual arrangements as the market for alternative providers increases.

‘The Panel were concerned that there does not appear to be an open and transparent protocol for monitoring performance in primary care, which is understood by the public and public agencies.’

The report added: ‘In the absence of any evidence to the contrary we have no reason not to believe that the reason for United Health UK’s decision [to transfer the Camden Road contract to The Practice plc] was their desire to concentrate on providing services to the GP commissioner consortia being set up under the National Health and Social Care Act 2012.’

Spokespeople for the United Health UK and the Practice plc were unavailable to comment.

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Company pulls out of surgery

Posted on June 27, 2012. Filed under: Closure | Tags: |

Leicester Mercury | 27 June 2012

A private company is pulling out of running a city GP surgery after protests from patients about poor service.

The Practice plc made the announcement as patients threatened to demonstrate outside the Brandon Street surgery, in Belgrave, and take their protest to local health bosses.

They said they were fed up that nothing was being done to sort out a catalogue of problems at the surgery, which moved from Cross Street, in Belgrave, to the newly-built Belgrave Health Centre, in Brandon Street, last year. Problems included concerns over the number of locum doctors being used, as well as difficulties getting through on the telephone and in getting an appointment after The Practice plc took over the running of the surgery in 2010.

It was part of a £5 million deal to run this and three other city surgeries for five years.

Ved Dhiman, chairman of the patients’ participation group at the surgery, said: “We were promised services would get better but the surgery has been run by locum doctors and patients have had constant problems in getting medication.

“We kept asking the primary care trust (PCT), NHS Leicester City, to do something about it and had meetings with The Practice, but nothing much changed. We were getting so fed up we were planning to demonstrate outside the surgery to let people know about our frustrations.”

The group was also planning to publicly demonstrate outside the PCT headquarters in Enderby.

However, on Monday evening bosses at The Practice said they were pulling out.

Dr Jeremy Rose, clinical director of The Practice plc, said: “We have had great difficulty in recruiting permanent GPs to maintain continuity of care for this group of patients – something that is very important to us.

“It is with regret that, by mutual agreement with the PCT, we have decided to release this contract for re-tender.”

The Practice will carry on providing services for the 4,800 patients registered at the surgery until the end of the year.

Mr Dhiman said: “I am very pleased this company is leaving and the patient participation group is sorry it has taken so long for people to listen to our complaints.”

Professor Azhar Farooqi, a city GP and chairman of the Leicester City clinical commissioning group, which will take on responsibility for providing health care in April, said: “Although we are not responsible for the contract, the most important thing for us is patients experience continuity of care.”

Lesley Harrison, associate director for primary care contracting at the PCT, said health bosses would be talking to patients to make sure a suitable provider is found.

Zuffar Haq, a spokesman for the Leicester Mercury Patients’ Panel, said: “It is about time the PCT got its act together for the people in this area. Things need to change.”

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