The mismanagement of general practice in Swindon and subsequent abrupt withdrawal of IMH means that five GP surgeries, over 100 members of staff and 54,000 patients now face an uncertain future.
Three partners are due to resign over the shambolic takeover of surgeries that took two practices from a CQC rating of good to requiring improvement or inadequate earlier this year.
Following an unannounced inspection at one of the surgeries affected Prof Steve Field, chief inspector of general practice at the CQC, said:
“We found there has been insufficient management infrastructure and insufficient leadership capacity and capability. There are significant concerns regarding the lack of effective governance and oversight to ensure quality and safety are not compromised.”
Primary Care Networks will be introduced in a matter of weeks and NHS England have no plans to ease this deadline for the practices affected.
The way private company IMH has run the five GP surgeries in the town has meant significant problems for patients accessing appointments since autumn.
The arrangement was presented as a way to relieve the burden on clinicians to focus on patient care and ease the crippling financial pressures caused by sustained underfunding of general practice.
However, those employing this company should have done their homework. IMH have a troubled history.
In March 2017 the company hit the headlines when one of their practices in Kent was found to have five receptionists but no doctors after full time members of staff resigned, leaving the practice relying on locums.
There are also other examples of practices across the country going from a good CQC rating to inadequate as a result of an IMH takeover.
Dangerous practices
Last year the Swindon Advertiser reported how the company quickly cut their costs by reducing essential administrative staff at practices by 50%. Without informing patient participation groups 75 staff were squeezed into the equivalent of 36 full-time roles, placing extra stress on those that remained.
A new call handling hub was introduced, immediately taking the time spent waiting on the phone to around an hour on average.
In addition, patients complained of dangerously muddled prescriptions, and long delays to access appointments.
According to a local member of staff working at the Great Western hospital one patient even required emergency surgery due to not being able to access their GP.
The situation deteriorated to such an extent that it drew the attention of the shadow health secretary Jonathon Ashworth who in November waded into the debate, raising the issue in parliament.
Following an unannounced inspection last month, the CQC issued IMH (now trading in Swindon as the Better Health Partnership) with an enforcement order to improve.
This prompted the resignation of Dr Peter Mack, the lead partner, from his director role at the CCG. IMH CEO Martin Diaper followed suit a week later.
After a protest outside the CCG by Keep Our NHS Public campaigners who have been exerting pressure from the start (photo above), the CCG finally informed IMH the contract had been breached, issuing a remedial notice requiring improvements.
The next day IMH announced their intention to withdraw from the five surgeries they were managing.
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What next?
With hundreds of GP surgeries closing around the country the CCG and campaigners have a difficult time ahead but a solution must be reached, ideally with an NHS provider taking over the reins. Kate Linnegar, Labour prospective parliamentary candidate who has been campaigning on this with Keep Our NHS Public since the problems started, says:
“It’s vitally important that the CCG oversee a smooth transition for patients who have suffered enough. Some NHS Foundation Trusts have taken GP surgeries inhouse, cutting out the need for a private profit-making company to be involved. I would urge Swindon CCG to consider this alternative.”
IMH have effectively driven a wrecking ball through general practice in Swindon and should be held accountable. Private firms can and will walk away when the going gets tough, leaving the NHS to pick up the pieces.
The NHS cannot and will not do this, and that is just one reason why privatisation poses such a threat to our health system.
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