APPLICATION TO CLOSE THE SURGERY
UPDATE – 20 SEPTEMBER 2017
The initial stage of the application process to close the surgery, which required the practice to enter a period of engagement with the 3,000 patients registered at Riversdale, is now complete. The practice would like to take the opportunity to thank patients who provided comments and also those people who took the time last week to attend the public meeting convened by the local Labour Party. The practice would like to assure patients that all comments will be taken into consideration and incorporated into the application.
Engagement versus consultation
It is worth highlighting that, at this early stage, no final decision has been taken. It will take some months for the application to go through the robust scrutiny processes of both NHS England and the final decision making body that is NHS Northumberland Clinical Commissioning Group (CCG). It should also be noted that the responsibility to engage with patients is on the practice and not the other organisations involved in the application process. Also, while the practice will take all feedback received into account, there is no requirement to conduct a formal period of public consultation.
The practice will continue to progress its application. It will now develop a full business case outlining patient feedback and any actions proposed by the practice in response to the issue raised, the case for change (including perceived benefits for patients), the financial implications and potential timescales. This will be submitted to NHS England who will assess the potential impact on other healthcare providers and whether there would still be sufficient GP services to meet local needs both now and in the future.
Once the business case is sufficiently developed the practice’s application will be discussed with Northumberland County Council’s (NCC) Primary Care Applications Working Group. This is attended by elected member of the council who are also members of the Health and Wellbeing Overview and Scrutiny Committee. The Applications Working Group will also scrutinise the application and can decide either to support it or refer to the scrutiny committee.
Once the application has gone through the levels of scrutiny outlined above a detailed report will be prepared for the CCG’s Primary Care Commissioning Committee, the committee given responsibilty by NHS England to make the the final decision. This committee includes officers and Lay Governors from the CCG and representatives from NHS England, the Local Medical Committee, Healthwatch Northumberland and NCC. This committee will consider all aspects of the practice’s application, including the views of the Applications Working Group and, if required, the scrutiny committee. The practice will be required to attend the committee meeting to answer questions.
It can be seen from the above that the practice application undergoes an extensive period of rigorous scrutiny and assurance. This may take some months to complete before a final decision is made by the CCG. In the meantime the practice will provide updates on progress on this webpage at each stage of the process.
Patients who attend our Wylam Premises will now be aware of our proposals to relocate services to a potentially newly refurbished suite of rooms at our Oaklands site in Prudhoe.
We propose that the new site at Oaklands will be open 5 days a week with no reduction in the service that we currently offer.
We have written to all households that currently use our Wylam site.
Dear Patients, Important information about Riversdale Surgery, Wylam
We are writing to let you know about the proposed changes to our Wylam site at 51 Woodcroft Road, Wylam and would like your views and feedback. We are proposing to close the Riversdale Surgery site at Wylam. All services delivered from this surgery would be relocated to newly developed premises at our branch site, Oaklands Health Centre, Front Street, Prudhoe.
For some time, the partners have been aware that the premises are becoming unfit for the purpose of providing modern day GP services. The current building at Woodcroft Road is a 3 storey converted Victorian semi-detached house. Staff and patients have to operate on 3 levels, there is a lack of space to integrate community staff, and there is no parking provision with associated traffic issues in Woodcroft Road. Recent CQC (Care Quality Commission) inspections have flagged issues that primarily relate to the ageing and non-purpose built structure of the building and it is becoming increasingly difficult to maintain the practice to ever tighter Health and Safety and Fire Safety standards on two sites.
In order to allow the continuation of Riversdale as a well-established practice, we have also had to consider succession planning in order to attract new Doctors to work in the practice in the future. The position across the country is that new GPs are not attracted to buying in to premises, especially old buildings that are no longer appropriate. Difficulties in future recruitment would significantly challenge the future viability of the whole practice. In order to provide our patients with a modern primary care service, we have considered a number of options but we see the closure of our Woodcroft Road site as the only viable option to enable us to maintain the current partnership and provide safe and effective modern day general practice to all of our patients.
The Oaklands site has space to develop a new, purpose built high quality premises which would make sure our patients have access to up-to-date facilities whilst being able to consult the same members of the team who will all transfer to the Oaklands site. The only service which will cease will be our dispensing service (see frequently asked questions below).
We appreciate that the proposal to close may be concerning and your views are important to us. We are therefore undertaking a period of engagement to seek your feedback on the proposals. We are working with various statutory bodies and Northumberland Clinical Commissioning group will make the final decision.
We have included below a list of frequently asked questions which we hope will answer any queries you may have. We will be updating these on a regular basis and they will be available on our website.
Frequently asked questions
We would like to thank everyone who has responded to our letter so far. We are grateful for the kind words, comments and expressions of thanks from many patients. It is fair to say that the majority of patients affected by the potential move appear to be supportive and understanding of the position we find ourselves in.
We have obviously also had a relatively small number of letters of concern about our proposals.
To answer these concerns we have collated the main themes of these comments below:
What will stay the same? All of the existing staff will continue to be involved in your care. The doctors, nurses, reception and administration teams will all move to the new site. We will offer the same services 5 days a week as we do now.
What will be different? The range of health services that the practice will be able to offer will be enhanced as all the health services offered by and attached to the practice will be housed under one roof. We are aware that approximately half our practice population will be required to travel under the proposed arrangements but are there are local bus services and we will arrange for surgery times for both GPs and nurses to coincide with the bus timetable as far as is practicable.
Disabled access to the premises will be significantly improved in new purpose adapted premises, with increased on-site parking including designated disabled bays.
Will there still be a dispensing service? Unfortunately, we will no longer be able to offer a dispensing service to patients. There is a pharmacy in Wylam and two pharmacies in Prudhoe which may be able to deliver your medication to you if you are unable to collect. There are also postal services which can send or deliver medication to your home.
If Wylam closes, will I have to register with another practice? You do not need to register with another practice as we will continue to see all our registered patients from the Prudhoe site. You can choose to register with another practice if you wish to do so.
I am a parent or carer for a Wylam patient and travelling to Prudhoe will be more difficult and time-consuming. What can I do? We will take individual circumstances into consideration and ensure that you can access the service as far as is practicable to fit your circumstances. There is a local low-cost transport service available which may help.
I don’t drive or have access to a car. How will I manage to get to and from Prudhoe? This is a personal decision but there is local public transport and we are looking at gathering more information about other available transport. We will also continue to provide daily telephone consultation appointments, and visits to our housebound patients just as we do now.
What will happen to my medical records? All records are fully computerised and we can currently access them at either site. Your paper record is securely stored at the site at which you are registered and therefore all Wylam records will be securely transported to Oaklands if the relocation goes ahead.
Telephone lines are often busy and it can be difficult to get through. Will this improve? Consideration is being given to the number of lines but in having all staff on one site, the ability to answer calls should improve.
What if I need to be seen urgently? Sufficient emergency appointments will be available at the Oaklands site. Patients that are effectively housebound will be visited as appropriate by the doctor.
Will opening hours be affected? We do not anticipate any change in opening hours; the only difference will be that we will be working from one site instead of being spread more thinly over two sites. We may review surgery timings across the day to maximise service. Community service provision will remain unchanged and in working alongside these services communication should improve.
My elderly relative with multiple health problems is currently in a care home in the Wylam area. What will happen? Care home patients who are house-bound will still be visited at home by GPs and community nurses, where appropriate. This will not change.
I am a dispensing patient. How would I obtain medication?
The practice would aim to establish an electronic link to local pharmacies to enable prescriptions to be transmitted directly to them with a view to patients collecting directly from the pharmacy of choice or taking advantage of a home delivery service if offered. For those patients living in Heddon, this may prove more helpful than the collection service currently available.
Local pharmacies already offer a delivery service covering Ovington, Ovingham, Heddon and Horsley.
There is no bus stop directly outside Oaklands Health Centre. How will I manage to use public transport?
We have discussed the addition or relocation of a bus stop at Oaklands with Northumberland County Council. The Council do not feel it necessary to add a new stop as they feel the current stops are already close enough to the surgery site and well within their current guidelines.
Adapt (NE) may be able to provide a fare-based dial a ride or hopper service, depending on demand and we will be actively trying to encourage this.
What happens if Ovingham Bridge is under repair again?
We have had to cope with the temporary closure of Ovingham bridge and previously of Wylam bridge. Thankfully they have not happened at the same time and so still allowed access across the Tyne. We cannot, however, hold responsibility for such closures.
Why can't you stay in the surgery? It isn't too bad.
Riversdale premises is privately owned and is not an NHS property.
One of the property-owning partners has already retired from the practice and wishes to realize the investment made in the building over many years. With other partners approaching retirement age we are trying to future proof the practice and avoid the situation where future doctors cannot be attracted to work here because of the need for potentially large sums of money to invest in premises which might be unsuitable for purpose in the future.
The practice building has become an increasingly difficult place from which to operate modern day primary care. It was never designed for our purposes and has actively curtailed our ability to provide wider team based services. It is multi-level giving access issues to disabled patients and staff. There is no designated parking space which results in congestion in a minor residential street.
Our other main aim with the relocation is to ensure that we can attract future new GPs without the burden of having to invest in potentially outdated practice premises. If we fail to do this and plan for the future the future of the partnership as it is at present may well be at risk.
Ideas suggested such as the installation of a lift and increased parking are simply not feasible in a Victorian building in a busy residential street.
Any setting for primary care (GP) services must be fit for purpose and inspected by the Care Quality Commission (CQC) whose standards are not unreasonably quite exacting, so it would not be feasible to operate from the Library or Institute.
Why didn't the practice seek to relocate into the old Wylam Garage?
The practice has been working over a period of time with NHS Property Services and NHS England to try to identify a suitable site. No alternative sites were suitable at the time of our consideration. Given that there is space to develop at Oaklands Health Centre, a decision was taken to focus on those premises.
Why were letters sent to households rather than individuals?
Rather than replicate identical letters, it was decided to save resource by sending out letters to affected households as advised during our consultations with the CCG and NHS England.
Any feedback can be sent to NORCCG.firstname.lastname@example.org or by completing a comment card in the practice by 11/9/2017.
Yours sincerely Drs Knapton, Miller and Donaldson Partners