This month has seen approval for major changes in GP provision in South Yorkshire with the South Yorkshire ICB giving the go ahead to a project in Sheffield to merge seven local GP surgeries into three large hub complexes and plans to merge four GP surgeries into new health hubs in Doncaster going out for consultation.
The projects will both be funded by the £57.5m allocated to primary care bids across South Yorkshire. The Sheffield project has been awarded £37m to ‘transform GP practices across the city’ and the Doncaster scheme will need almost £13m of the funding.
Primary care in the area is badly in need of investment, but the plans to merge GP surgeries has been controversial. Public consultation and criticism from councillors has meant that the initial scheme in Sheffield for the closure of 15 GP surgeries and building of five hubs, has been scaled back to seven GP surgeries closing and the building of three hubs.
The ICB hopes that new buildings will mean more services located together and entice more staff to the area as recruitment is a major difficulty at the moment.
Dr Ben Allen, GP and NHS South Yorkshire clinical director for primary care in Sheffield told local media that the primary care hubs will help attract and train more staff, create more space to increase services on one site, and improve access, however he acknowledged that “ new buildings alone won’t solve all the problems facing GPs.”
Back in March when councillors first scrutinised the original proposal to close 15 GP practices and build five hubs, Coun Abtisam Mohamed on the City Council was critical of the plans:
“It goes against everything we stand for in the council in terms of localising provision and making sure that communities are a central part of every decision that we make in terms of that care and our support. This is about people who are vulnerable, who will be ill, who need localised support within their community. It doesn’t put patients at the heart of delivering care….All I see is a service that’s going to be reduced for people with mobility issues that have less access.”
The new plans, despite the reduction in closures of local GP surgeries, will still result in many patients being much further away from their GP.
Professor Andrew Lee, a GP and professor of public health at the University of Sheffield, told Pulse that there is a concern that with consolidating those practices into health centres it may make it more inconvenient for patients to access the clinics, especially for those in deprived neighbourhoods.
However, due to the lack of major investment and improvements to the physical buildings for decades, this is a “rare opportunity for these practices to modernise their infrastructure.” Adding that economies of scale will also be important due to lack of money.
The issue of more difficult access for patients, he suggested, could be addressed to a degree by using video and phone consultations.
The proposals for Doncaster include the move of patients and staff from the Don Valley Healthcare Centre and the Ransome Practice to new premises on the site of a former community library on Chapel Street, in Bentley and the Rossington Practice and West End Clinic to be relocated to a new building on the site of a former colliery. The investment required for the Bentley hub is £5.62m and the Rossington hub is estimated at £7m.
Once again many patients will find themselves much further away from their GP surgery. A consultation process is now underway until early April for the public to make known their views.
Criticism, however, has already been voiced by local GP leaders, saying it could cause ‘financial hardship’ for the practices involved.
Dr Dean Eggitt, Doncaster LMC’s chief executive officer, told Pulse that these types of plans have been around for years as a national strategy, but they aren’t good for patients as they often have to travel further to the new hubs and they boost costs in the long-term for GPs. He noted that “some may argue that this will bring integration of care, but integrated and localised care are not the same.’
He added: ‘The new premises are very well known for causing financial difficulties and hardship for GPs….By moving the practices somewhere else, you add time and financial costs for the patients too and you are more likely to worsen patient outcomes.’
ICBs and their use of public consultation has come under close scrutiny recently with the awarding of a contract in Lancashire to SSP Health, with virtually no public consultation. The ICB in this case has just backed down in the face of public opposition to its decision and willnow rerun the procurement.
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