14.10.16
Plans to allow GP practices to wither and fail ‘unacceptable’
Support funding could be denied to GP practices if they fail to adopt new NHS reforms, a leaked letter suggests.
The letter, from Dr Paul Twomey, medical director of the NHS England North Yorkshire and Humber area team, to local GPs, indicates that the GP Forward View will not support GP practices that fail to commit to service transformation.
The Forward View was intended to help general practice address the challenges it faces, which include financial problems, increased demand and GP shortages.
Dr Twomey said: “The message we need to communicate to general practice is the GP Practice Forward View must be about transformation and in that sense is not like a pilot.
“This is what we do need to explore I think in particular with the LMCs, who on the whole across Yorkshire do have a commitment and focus of quality, and appreciate that vulnerable practices must either transform and deliver a quality service or be allowed to fail and wither by the system.
“We are no longer in a position to continue supporting practices irrespective of their willingness or ability as a provider to transform appropriately.”
But Dr Mark Spencer, co-chair of the New NHS Alliance, said everything must be done “to support each and every GP practice while we work through planned transformation”.
“To allow a practice to fail and wither is unacceptable,” he said. “It will have a significant impact not only on patients from that practice but also neighbouring practices who will be put in a vulnerable position.
“We may see a domino effect in the community, and see a real impact in services available for our patients. Communities will suffer. The knock-on effects of a failing practice will ripple right through the NHS with patients ending up in A&E which is the last thing that anybody wants.
Dr Spencer added that the vast majority of practices that are termed ‘vulnerable’ are good practices buckling under workload increases and significant recruitment and retention issues with clinical staff.
“It doesn’t take much for a practice to go from just surviving to falling over into a situation where they are no longer viable because they’ve been allowed to fail,” he said. “Practices find themselves in this state through no fault of our own, we should be supporting every practice in the country.”
Dr Richard Vautrey, deputy chair of the BMA GPs’ committee, said that the letter showed that “the term ‘transformation’ seems to be taking on Orwellian tones”.
An NHS England spokesperson said: "Rising patient demand is placing GPs under more pressure and that is why we are reversing the historic under-investment in general practice through a wide-ranging action plan, backed with half a billion pounds to support struggling practices.
"This includes a four-year, £40m programme for helping the GP surgeries facing the most difficulties and further practical measures to stabilise general practice for the future."
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