Civil unrest will be inevitable… This is the future … “Super-surgeries with 50,000 patients” – take it or leave it..

Most of us in the professions are disengaged from the political process of imposing change on an unwilling population. Ever since E. F. Schumacher we know that “small is beautiful” and that individual personal continuous care is what patients would prefer. Citizens prefer to die early (as a group) rather than to have services at inconveniently distant from them. Access is important, and patients and infrastructure are not ready for the forced changes that are coming. Civil unrest is going to be inevitable.. We will have to “take it or leave it”, and NHSreality predicts that those who can afford it will leave and go private. Doctors will respond in the same way as the dentists have.. and Aneurin Be van’s dream will be far from reality as fear returns.. Rationing by size, bureaucracy and distance, against their will, does not make people feel as if they matter….

Image result for small is beautiful health cartoon

The Bournemouth Echo report: Super-surgeries with 50,000 patients: the future of GP care in Dorset

‘SUPER surgeries’ with up to 50,000 patients could be introduced in a radical shake up of GP services in Dorset.

Dorset Clinical Commissioning Group (CCG) has outlined a new ‘integrated GP model’ which would see groups of practices abandoning existing buildings and working together on hub sites in a bid to cope with growing demand, an ageing population and an ongoing GP recruitment crisis.

In a draft report of the Primary Care Commissioning Strategy and Plan seen by the Daily Echo, the CCG has set out 13 ‘local blueprints’. It proposes the number of GP surgery sites could be more than halved from 131 different sites to between just 36 and 69.

In central Bournemouth alone 10 sites, used by seven practices, could be reduced to just three.

The county has 97 GP practices serving 766,000 patients.

No surgeries have thus far been named in the draft plan which is being put to each blueprint area for consideration.

The CCG cannot force any change and it is up to individual practices to decide whether to move sites or not.

The proposals come as the county faces a crisis in general practice due to ‘significant pressure’ and ‘unprecedented levels of demand’, the report says.

A Daily Echo investigation previously reported services were ‘stretched to breaking point’ due to a GP recruitment crisis which has already led to closures and some surgeries being forced to merge.

CCG head of primary care Rob Payne said: “We want to be absolutely clear that we have no plans to close any practices and any claims that we do are inaccurate.

“We are in fact actively working across Dorset to support practices where they are facing the greatest pressures.

“Primary Care faces a number of challenges in the future, and if we continue as we are doing, our workforce and finances could soon become overstretched.

“The draft Primary Care Commissioning Strategy and Plan considers how services could be delivered differently to ensure they are safe and sustainable for the future; for example consolidation of sites or back office functions.”

“This draft version of the strategy which is on our website has been circulated to key stakeholders to gain their views.

“Our ongoing strategy is to work with local groups of practices to help shape the way in which we will deliver services to meet future population needs.

“This includes looking at how we would support new models of care.

“It is up to individual GP surgeries to decide whether to merge or not as they are independent contractors, we cannot force any change.

“We have been listening to the pressures that General Practice faces and it is clear that practices will have to work together and explore new ways of working and looking at transforming the way care is delivered if we want to ensure that services are sustainable in the future.”

The 52-page report states: “We need to reduce the number of buildings across primary and community estate by bringing together services under one roof, using the buildings more efficiently, and increasing their use over seven days.

“With new practice groupings, more efficient ways in working and the use of technology, the number of buildings needed across Dorset will be reduced.”

It says: “Our reasons for change are simple: General Practice in its current form will find it difficult to survive, if it does not evolve.

“At its heart is the belief that General Practice in 2020/21 will not look the same. It will be able to work at scale making best use of new technologies and increases in the workforce; so that clinicians can devote the greatest possible amount of time to quality and health improvement for patients and local communities, and be part of a more joined up local services.”


This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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