News in brief… In this edition we bring you news of the merger between St Stephen’s Surgery (Town Centre) and Maple View Medical Practice (Church Hill) in Redditch. The senior doctors (Partners*) and practice teams have been building towards this for a number of years but the end is in sight when in April 2021 the two GP Medical Practices will finally merge their patient lists (about 11,000 at St Stephen’s and 6,000 at Maple View), leading to a larger combined list size of about 17,000 patients. There will be several significant advantages to this, in particular, a wider and larger skill-mix of healthcare professionals – not only doctors and nurses, but also physician’s associates (PAs) and clinical pharmacists to name a few. Both practices have also been part of the Kingfisher PCN (Primary Care Network) with several other Redditch GP practices – The Dow Surgery, Elgar House Surgery, Hillview Surgery, and Bridge Surgery – and there will be more news concerning the PCN in future newsletters. For now though, we give more details concerning the merger, along with some FAQs about GP practice mergers in general. *Drs Catherine McGregor, Richard Burling, Mark Talbot, Anil Joshi, Liz Ordway, and Kerry Walsh Merger of Maple View Medical Practice and St Stephen’s Surgery
In April 2016 NHS England published the General Practice Forward View. In the introduction Simon Stevens, Chief Executive of NHS England states:
“There is arguably no more important job in modern Britain than that of the family doctor. GP’s are by far the largest branch of British medicine. A growing and ageing population, with complex multiple health conditions, means that personal and population-orientated primary care is central to any country’s health system. As a recent British Medical
Journal headline put it – “if general practice fails, the whole NHS fails”.”
Unfortunately the NHS and in particular General Practice is under increasing pressure. There is a growing population, and that there is an ageing/elderly population with increasingly complex health needs requiring more time and continuity. The NHS is able to offer more treatments and more complex care, requiring more resources, so the social care and community support is being spread more thinly. We now have to deal with a world-wide crisis and ensure that we provide the same level of care to our patients. All of this while there is a recruitment and retention crisis in the NHS, to which our practices are not immune, but we have clear staffing plans in place and are managing to continue to extend our access and improved opening times in line with the National direction.
The Redditch population is increasing with more housing developments, and this puts pressure on the health economy to offer every resident in Redditch the same healthcare opportunities afforded to all.
Across the county smaller surgeries are no long able to run and are closing at an unprecedented rate. Sizes of practices need to be larger to be sustainable and offer the range of services needed in modern general practice.
With this in mind the Partners of both surgeries are considering the following:
1) Continue the status quo. Comfort is taken from a system that is understood. However, in doing this we must acknowledge that there is a significant risk that the Primary Care services that we currently offer will not continue in its current state.
2) Innovate and look at system wide change with a view to offering long-term and best quality General practice services for our population.
This is difficult but provides a service that looks after the patient as a whole and is not fragmented and disjointed by the need to use different providers in the community.
With the mergers of St Stephen’s and Maple View, our Practices are addressing this issue with a view to providing stability to our practice, by increasing the skills of our staff and clinicians, and an increased ability to adapt to change.
Being a larger practice gives us opportunities to offer more services locally for our patient population. There are benefits of working at scale such as being able to share workload, give access to patients to a wider set of specialist services because of the skill mix from the two teams, and ensure rapid emergency cover for staff absences. This then becomes more attractive to the multi-disciplinary teams as a place to work, thus helping with our recruitment and retention.
With an increased size comes a boost to resilience and sustainability. The average practice list size in England is 8843 patients, and our combined list would be 17,000.
NHS England along with our Clinical Commissioning Group is keen for primary care to take on more services from secondary care and greater collaboration is needed across health, social care and the community to ensure seamless continuity of care.
At the same time we need to maximise the income we receive to offer a wide range of services and best value for money. This is not as feasible as single practices; being a bigger organisation gives us the opportunity to offer more services locally for our patient population and gives us more options as an when more funding becomes available.
It is a fine line between offering unlimited on the day access and regular routine appointments and we must acknowledge that at times the balance can go either way, but it is with an understanding and open mind that we move things forward, learning from what we have achieved in the past to improve and redesign for the better in the future. We are in a time of significant change and all of the staff at St Stephen’s Medical Partnership are looking to providing outstanding care for our patients. However, we can only do this with the support of our patients. We must adapt to patient’s needs, always be open to suggestions, but maintain our desire to move the practice forward to what we believe it can become.
With this in mind that we have applied to the Clinical Commissioning Group to formally merge our surgeries, building on our joint and cross working that is already done across both sites.
GP Practice Merger Patient Frequently Asked Questions
The following questions and answers have been prepared to assist all patients of the St Stephen’s Medical Partnership who, subject to all regulatory approvals, intend to merge to form a single GP Practice.
Q1 When will the merge to the new Practice take place?
It is anticipated that the merge will take place in April 2021 subject to all regulatory approvals and following extensive engagement with patients and all of the staff.
Q2 Will I still be able to make an appointment to see my usual doctor or nurse?
Yes. We very much value all of the one to one relationships our patients have with our doctors and nurses. It is therefore expected that merging practices will further increase our ability to provide you with continuity of care and access to your usual doctor and/or nurse.
We also expect to be able to reduce the need for locum doctors and provide you with a greater number of highly skilled local doctors and nurses in the event that your usual doctor or nurse is absent from work.
Q3 Will I still be able to make appointments at my usual doctor’s surgery?
Yes. We will continue to provide daily appointments to see doctors, nurses and healthcare support workers.
Q4 Will my usual surgery opening times stay the same?
Yes. We are not currently anticipating any changes to our core opening times.
Q5 Will there be changes made to the way I book appointments?
No. We are not currently anticipating any changes to the way you book appointments and you will therefore continue to be able to book these in the same way as you do now.
We will also continue to contact all of our patients who require scheduled vaccinations, chronic disease reviews or routine screening eg cervical screening tests, etc...
Q6 Will I have to go to another GP practice site for consultations and/or treatments?
You may be offered appointments at another site. This maybe because the other site offers more specialised treatments or more appropriate service for specific patients – for example a particular nurse at one site may specialise in COPD or diabetes – you may be asked if you would like to attend there in order to access more specialised care if this is appropriate and you can choose this option.
It maybe that the other site as it is more convenient for you to attend, giving you more options.
Q7 Will any service that is currently offered by my usual surgery be removed or stopped?
No. We do not anticipate services being removed or stopped. If anything, we anticipate that this merger will bring about a greater choice of services.
In the event that the contracts against which we deliver are changed by our NHS England or the Clinical Commissioning Group, we would be unable to influence these changes.
Q8 Will there be any changes to how I access the GP out of hours service?
No. In order to access a GP when the practice is closed, you will still continue to telephone the NHS 111 service and they will either signpost you to the most appropriate service or arrange for you to access a GP.
Q9 Will the current arrangements that I have in place for getting my medicines stay the same?
Yes.
Q10 Will the intended merge affect any treatment or medication I am currently receiving either at my usual surgery or any hospital?
No. Any current treatments, medications or investigations will not be affected by our intentions to merge.
Q11 Will I need to re-register to become a patient of the single GP Practice? What will happen to my health records?
No, you will not need to re-register; you will remain registered with the same GP as you are now.
All of our patients’ records will automatically be merged into a single GP Practice and your health records will reside within a single patient database. The NHS safeguards in relation to patient confidentiality of information will continue to remain in place throughout the transition.
Q12 What will happen to my medical records?
When practices merge, the clinical systems in each practice will also merge into a single system. This is an automated process and patient information will be transferred automatically. The new single system will allow the merged practice to work as a single organisation, providing you with safe and effective care, as we do currently.
Q13 Will the single GP Practice be able to provide new services to patients?
One of the main reasons to merge and form a larger practice is for us to be able to expand the services that we are able to provide locally. For example, we hope to be able to include access to see other healthcare professionals e.g. pharmacists for medication reviews, physiotherapists etc.
Q14 How will the new arrangement benefit GPs and Nurses at the practice?
Our GPs, nurses and healthcare support workers will all have access to a wider pool of clinical knowledge and expertise to draw upon and we will have far greater opportunities to specialise in areas such as diabetes, care of the elderly, palliative care and urgent care access.
We anticipate that the current level of administrative tasks that our clinical staff performs will benefit from economies of scale by joint working; therefore allowing the administration team more time to spend on responding to and delivering the clinical care our patients need.
We will be able to better cover any planned or unplanned absences which we hope will alleviate the resulting pressures felt by remaining staff. In addition, we should also be able to reduce our reliance on expensive locum and bank staff, who you may not be familiar with.
We also anticipate that all of our staff will be provided with greater opportunities for enhanced training and career development.
Q15 I am concerned that the practices will be taken over by a private provider
The decision to commission GP services from a particular contractor lies with our Clinical Commissioning Group, not the partnership, under strict governance arrangement and NHS Regulations. The intention is to keep the GP services provided by our local GPs. On the contrary, we are joining forces to sustain and preserve local provision of local healthcare for the foreseeable future.
Q16 If nothing is changing for patients, what are the benefits of merging?
Patients will benefit from continuing to have access to local GP services, a stable workforce and access to the wider skills and knowledge of the combined teams.
Q17 I am concerned that my local practice will lose its identity as part of a bigger organisation.
We are keen to preserve the local flavour of each practice under the umbrella of the newly merged contract, retaining their individuality where practicable, sharing the resources of the combined team to establish a stable workforce in each site. Being part of a bigger organisation will give them a stronger voice in the community and the wider Primary Care Network (PCN).
Q18 How can I be involved?
You are invited to join the Patient Participation Group (PPG). PPGs can bring significant benefits to a GP practice: improving services, allowing resources to be used more efficiently and, most importantly, developing mutually supportive networks. You would be most welcome to join, please contact the practice manager for more information.
Q19 I have further questions I would like to ask and/or comments I would like to make. How do I do this?
You can put these in writing for the attention of the Practice Manager at your usual surgery:
Judy Langford
Maple View Medical Practice
Churchill Center
Tanhouse Lane
Redditch
B98 9AA
Lisa Luke
St Stephen’s Surgery
Adelaide Street
Redditch
B97 4AL
OR...
Healthwatch Worcestershire The Civic Centre Queen Elizabeth Drive Pershore WR10 1PT 01386 550264 www.healthwatchworcestershire.co.uk