Last Updated: 10 June 2019
Created: 10 June 2019
Last week I met with the Chair of the Swindon Clinical Commissioning Group following the announcement that IMH would be withdrawing from Swindon.
I have also been in regular contact with the Care Quality Commission following my meeting with them the week before.
So what happens next now that IMH have said they are withdrawing?
For the immediate term, IMH have said that they will have a phased exit whilst the CCG work to find a local solution. Obviously the sooner this solution can be found the better as the service under IMH has been very poor. But for now, this means that appointments won’t be cancelled and patients can still contact the hub in the same way.
The CCG will be working closely with NHS England and other local surgeries in Swindon (who are already working well in effective partnerships) to deliver a solution for the 5 surgeries which will ensure that the back office operations are covered and GPs will continue to work there with hopefully more clinical staff taken on board. I will continue to work closely with the CCG and have written to NHS England to ensure that they provide as much support as possible to the CCG during this process.
What went wrong with IMH & have lessons been learnt?
IMH offered the GP partners at the surgeries a solution for their back office operations. GP partners have a number of issues they have to face including complex issues with the buildings as well as other admin tasks including HR. Much of this can detract from treating patients but it also puts a lot of additional stress on GP partners. This is why more newly qualified GPs are choosing to become locums instead of GP partners, and why many are retiring early or choosing to reduce their hours each week. These are issues that have arisen over a period of 15 years or so since the GP contacts changed in the early 2000s.
IMH offered the GPs solutions to help them with the back office and allow them to spend more time treating patients. After initial good reports following action taken at Abbey Meads & Eldene surgeries, the GPs commissioned the services of IMH.
Everybody has since acknowledged that the whole process happened far too quickly, without any proper road testing. Especially on the day that the phone lines for all 5 surgeries were combined into 1, completely underestimating the number of calls they would be receiving each day.
Ultimately, the Hub joined each of the surgeries together overnight, despite the fact that there were 5 very different systems in place at each surgery and each with their own individual governance structure and way of working.
It was a very frustrating time for patients (myself included!) and I continued to raise concerns & residents’ experience with both the CCG & CQC. Both ended up putting pressure on IMH before finally saying that enough was enough.
Lessons have been learnt. Such a big change should never be done overnight, especially not with 5 surgeries who each have individual processes in place.
What are Primary Care Networks (PCN) & should this experience put us off them?
No it shouldn’t put us off them. I have been told by a number of GPs that when working well, Primary Care Networks are a good thing and a positive step forward for Primary Care. A number of local surgeries in Swindon are already operating in these partnership models, for example there is the Wyvern Health Partnership & the Brunel Partnership.
What the model allows local surgeries to do is combine and therefore share the burden of back office costs, provide more GPs with more specialisms, provide cover across surgeries when there is a sickness (very important for smaller surgeries), allow patients to see physios & other clinical staff without needing a referral, and allow best practise to be shared across each surgery. Ultimately, patients are provided with better care and importantly, the particular care that they need.
I will continue to work with the CCG to ensure that the PCNs can work for these 5 surgeries, and that the failures of the IMH attempt have been well learnt.
Update on Moredon Surgery:
Unfortunately there are 3 GPs who are leaving Moredon. 1 is retiring and 2 are going to work elsewhere.
I have discussed Moredon in detail with the CQC and following the issuing of their report, I received the following update from the surgery:
“The health and wellbeing of the patients at all our medical sites has always been our top priority. We are deeply disappointed by the findings of the CQC report. We sincerely apologise to our patients and colleagues and fully accept the impact our shortcomings may have had on them. A comprehensive review of our procedures is underway, and we are already working closely with the CCG and CQC to improve the systems and services we offer. As part of this we have already recently implemented several measures, including a local leadership change, recruiting more GPs and introducing a new complaints system so we can effectively respond to patient and staff feedback. Since the inspection we have also reviewed and responded to 98% of the outstanding correspondence. We are fully committed to improve the standard of care we provide and will continue to strive to do better for our patients and colleagues.”
I wanted to say a big thank you to all of the residents who raised complaints with me – each and every one helped to highlight the issues that were going on and further demonstrate that the ongoing service from IMH wasn’t acceptable.
I will continue to work closely with the CCG, CQC & NHS England to help ensure that this process is carried out as smoothly as possible with improvements delivered.