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CCG bans patients from leaving hospital-managed GP practice amid exodus

by Tom de Castella
17 January 2019

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GP patients in Gosport have been banned from switching surgeries after a dramatic exodus of patients from a hospital-managed GP practice left others overwhelmed.
The Hampshire town has seen 2,100 patients transfer to different practices after problems at the four-practice Willow Group, managed by Southern Health NHS Foundation Trust.
NHS Fareham and Gosport CCG, which took the decision, said the three-month restriction will remain in place until 31 March.
The Willow Group was formed in April 2017 when four practices merged with Southern Health NHS Foundation Trust, with GPs becoming salaried to the trust, in a bid to avoid closure in light of severe recruitment problems.
The blanket ban on moving GP comes after two Gosport practices closed their lists after struggling to cope with the sudden increase in numbers. This led to a knock-on effect on nearby practices which raised safety concerns.
As a result the CCG decided to stop all transfers until April, when it is hoped the GPs will be under less pressure.
CCG spokesperson Dr Andrew Holden said: ‘We are not taking the decision lightly to support temporarily suspending a patient’s ability to move to another GP practice. But the current situation poses considerable risks.’
Urgent action was needed to prevent new arrivals in the area being left in the lurch, he said.
‘If more practices suspend patient registrations, then people moving into the area may not be able to find a doctor at all, which is unacceptable. We are also very mindful of practices’ concern that they could have a list size that is unsafe to manage.’
He added: ‘This temporary suspension will give the practices some time, in a planned and co-ordinated way, to catch up with the influx of patient registrations received to date.’
Dr Holden said that allowing patients to move in order to find quicker appointments was no longer a solution.
‘We would ask patients to bear with us at this time and understand that, if they are considering moving practice, for whatever reason, that all of the practices are committed to providing the best services they can.
‘The shift in patient numbers means that a practice which, a few months ago, could potentially offer a faster appointment than elsewhere may not still be able to do so.’
Dr Nigel Watson, chief executive of Wessex LMC, said the Willow Group had lost a significant number of partners in a short space of time, then struggled to replace them, meaning that patients couldn’t get appointments with the result that they re-registered elsewhere.
And, although it’s not unusual for practices to sometimes close lists, it was unusual for a CCG to put in place a blanket ban on patients moving surgeries, he added.
Dr Watson said: ‘Where it’s unusual is the blanket ban on people. In hindsight you always wonder what you can do differently. Ultimately we have got to address GP workload issues [for the profession in general] because we’re driving GPs away.’
Gosport MP Caroline Dinenage, a health minister, has told local media that constituents raised concerns throughout 2018 about the Willow Group. She said the complaints were about a lack of appointments and problems with the telephone system.
Dr Robin Harlow, GP and clinical director at the Willow Group, said: ‘We are working closely with our colleagues at the CCG and the other surgeries in Gosport to stabilise the situation, support each other and enable patients to move freely again, should they choose to.
‘GP recruitment and retention is a national issue and one which is being felt particularly hard in Gosport. This has created challenges with patients accessing primary care in the area which is why we continue to invest in, and explore, new ways of working for our patients.’
He said this included investing ‘significantly’ in a new telephone system ‘to improve access’, and apopting ‘new technology such as E-Consult, which we strive to respond to on the same day’.
The Willow Group has also developed an ‘extended primary care team’, which manages people with long-term conditions and ‘offers patients the opportunity to see other health professionals that might be more appropriate for their needs’.
The news comes as an investigation by our sister publication Pulse last year revealed that the number of GP practices closing their lists to new patients had started to taper off, after rising for several years.
A freedom of information request to NHS England showed 106 GP practices closed lists to new patients in 2017/18 – compared with 145 in 2016/17 and 175 in 2015/16. 
This story was first published on our sister publication Pulse.