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Vulnerable practices should be ‘allowed to fail’, says NHS England official

13 October 2016

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An NHS England official said vulnerable practice must “transform… or be allowed to fail and wither” in a document leaked to Pulse and the BBC.

Paul Twomey, medical director of the Yorkshire and Humber area team said in a briefing sent to NHS managers and GP leaders in the region that NHS England is “no longer in a position” to support practices “irrespective of their willingness or ability” to transform.

NHS England has been encouraging practices to merge and form federations but this is the first time a medical director has explicitly mentioned allowing practices to fail.

Twomey wrote: “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.”

In response, Dr Peter Swinyard, chair of the Family Doctor Association, told Pulse: “Starve the practices of resources. Micromanage them into the ground. Over inspect and over criticise. Then stamp on them.

“It is hard to be transformative when you cannot recruit doctors or nurses and are under the cosh of all the stresses we know, then have your income and resources reduced making it even more likely that you cannot manage change and adapt.”

He added: “This is the most desperate and negative policy I have heard.”

Jonathan Ashworth MP, Labour’s shadow health secretary, said: “This is bad news for struggling GP surgeries and the patients who rely on them.

“Allowing local GP surgeries to fail will only make it harder for patients to get an appointment when one in four patients already have to wait a week or more, or don’t get an appointment at all. In some areas patients could be forced to travel miles and miles to see a GP.

“It is unacceptable for vulnerable GP surgeries to be allowed to ‘wither away’ and this Tory Government needs to take action to protect those surgeries and the patients they care for.”

Twomey would not comment, but an NHS England spokesperson said his comments “do not reflect national policy whatsoever”.