Agenda item

Media Issues

Verbal report of the Principal Overview and Scrutiny Officer including a review of service provision by Skerne Medical Group

Minutes:

·         Surgeries to close due to GP shortage – Northern Echo 22 October 2018

A county Durham medical group is planning to close two surgeries because it does not have enough GPs.  Skerne medical group which has four surgeries in Sedgefield, Fishburn, Trimdon Colliery and Trimdon Village says it is reviewing its operations with a view to keeping a maximum of two sites

 

·         Fears for Bishop Auckland Hospital amid 24-bed ward closure plans – Northern Echo 3 October 2018

Fears have been raised about the future of a County Durham hospital after it emerged a 24-bed ward could close.   Last night County Durham and Darlington NHS Foundation Trust confirmed it was consulting on the closure of Bishop Auckland Hospital’s ward six.

The nurse-led ‘step down’ ward is for patients who no longer require doctor care but are not ready to go home.

 

·         Public meeting over closure of Bishop Auckland Hospital ward to be held tonight – Northern Echo 18 October 2018

Campaigners fighting to keep Ward 6 at Bishop Auckland Hospital open will air their views at the meeting, hosted by the town's MP Helen Goodman.

 

 

 

The Chairman introduced Dr Hearmon from the Skerne Medical Group.

 

Dr Hearmon gave a detailed update on the current situation facing the Skerne Medical Group.  She advised the committee that the practice was facing a crisis and was unable to fill current vacancies.  She advised that the group would be closing one of the branches and reducing the services across the other three sites so that the remaining partners could continue to deliver safe quality medical care.  The group look after 15,000 patients in Trimdon Colliery, Trimdon Village, Fishburn and Sedgefield.  The group were struggling to recruit and retain GPs.  New housing developments in the area had led to an increase in patient number and no-one had asked if the group had the capacity to take on extra patients.  The group had suffered significant losses and were unable to continue to provide services that patients would expect.  The partnership model for the group was eight GP partners supported by a small number of salaried GPs.  There were 8.62 full time equivalent GPs in October 2016 however this could reduce to 5.1 in February 2019 and therefore the group would be able to offer 41 sessions, reducing from 69.  The group had been trying to attract new GPs with a permanent advert on the NHS jobs site however no suitable response had been received.  The operation from four sites was causing the existing GPs to leave and stopping potential new recruits from joining.  Engagement meetings were being held to gain an understanding from patients on how to deliver a safe service.  In the short term the group do not have the capacity to staff the existing four sites and in the medium to longer term there would need to be a reduction in surgery site.  The Committee were assured that the remaining staff jobs were safe and the group would continue to try to recruit and retain staff but felt that this offer would be strengthened by operating from fewer sites.  The group appreciated that patients required easy access and there was no intention to disadvantage those patients with poor health or those with economic reasons.  Transport had and would always be an issue with accessing health care.  Buses run hourly between the villages and there was the use of a volunteer driver scheme.  The offer of home visits would not change and the group had taken on extra clinical practitioners and a paramedic to help maintain the service in the absence of GPs.  The group want the model of care to be fir for the future and if they did not make any changes they ran the risk of losing further staff due to stress and sickness.  If this was the case an alternative provider would need to be sought.

 

The Chairman thanked Dr Hearmon and the practice manager for attending the meeting and asked if they could come back to the special meeting on 4 December to report back on the findings of their consultation exercise.  He referred to a request from the Chairman of the Health and Wellbeing Board, Councillor Hovvels, and requested that the Trimdon surgery be added to the review, even if this meant a three year review into services.  The Chairman further asked what role the CCGs had played in this decision, as he was increasingly concerned that this would have a domino effect across the County.  He suggested that a cross party working group be established to review GP services in the County.

 

The Chief Clinical Officer, DDES CCG said that this was a very difficult situation and one of many facing GP surgeries in DDES and North Durham areas.  A lot of GPs were being lost to retirement and new GPs preferred to work in cities and therefore were difficult to recruit.  The average number of patients in the North East per GP was 2142 however this increased to 2372 in DDES and 2250 in North Durham making it even more difficult to recruit.  The CCGs had been working very closely with Skerne and a lot of work had been undertaken with a national recruitment drive.  In addition to that a career start scheme had been introduced with 41 additional GPs being recruited.  However over the next 10 years 21% of GPs were due to retire.  Older GPs were being encouraged to stay on and more nurses had been recruited.  He added that the Skerne Medical Group were a very popular practice and the CCG fully supported them with their current line of engagement.

 

Councillor Grant expressed serious concerns about the closure of the Trimdon Village surgery as this would leave 3000 patients without health care in their village, making them travel to another area for treatment.  A lot of people had already been encouraged to attend the Fishburn site.  She also had concerns that the group wanted a four year review, that this was too long and that Trimdon Village should also be included in that review.  She felt that decision had already been made despite the engagement process.  She did sympathise that there was a shortage of GPs but asked how this had crept up and who was to be held accountable.  She said that the people of her community deserved safe care and half of her ward were faced with this permanent closure and the other half having to attend a practice that had been marked as inadequate.  She believed that moving the practice onto one site would fall nicely with rooms at Sedgefield hospital having to be filled.

 

Councillor Hopgood fully supported the establishment of a cross party working group.  She was disappointed at the news but not at all surprised that no-one at the practice had been consulted on new homes having been built.  She strongly urged that this was looked at in terms of planning as this should form a big part of the consultation.

 

Councillor Kay said that this was driven by logistics and not patient care.  He commented that as this was a verbal report he had not been able to fully scrutinise it before the meeting.  He asked how it was so difficult to recruit GPs to rural areas as this was once a sought after job.  He concurred with Councillor Grant’s point that this was a primary driver to fill up Sedgefield Community Hospital.

 

Dr Hearmon said that they had focused on the Trimdon site as this was the smallest with only one room for a doctor and one nurses room and no availability for any other staff members.  Most patients attended the Fishburn or Trimdon Colliery sites from the Trimdon Village area.  She added that to continue to staff this site was a drain on the available resources and overall care for patients.  The four year plan would encompass three sites as come February 2019 there would not be enough doctors to staff the Trimdon Village site.  There was a significant timescale to require or improve what meets the needs of the medical group and there was a need to ensure the medical care was met for the future.

 

The Chief Clinical Officer DDES CCG also welcomed the cross party working group and would be pleased to work with colleagues on this.  He advised that a retirement scheme was in place for GPs and that the CCGs supported part-time working for GPs.  The problem with recruitment was multi-factorial as the number of recruits to medical school had increased however most chose to practice in cities or to work part-time.  A further problem was that 9% of doctors were from the EU and it had been difficult to recruit them over the last couple of years due to Brexit.  With regards to Sedgefield Community Hospital he advised that it was full and there was no financial reason to move a practice to this facility.  He advised that there was land suitable in Trimdon Village but that all options must be explored first.  Referring to the inadequate practice he advised that the CQC look at systems and not the quality of the clinicians working in a practice.  So, in this instance it was a systems risk rather than a clinical risk.

 

Councillor Hovvels, as a local member, found that this was a difficult position to be in and that the potential branch closures could be the first of a domino effect.  She also welcomed the cross party working group and would like to see this extend into the dentistry and care sector.  With regards to Planning she advised that there was a named person in the NHS who received details of any planning applications and she had been working with them on improving this.  She asked that the proposed Skerne Group review included all four branches and support the voice of the local people.

 

Councillor Brookes did understand the shortage of GPs and the issues around recruitment and retention however he did not see this way forward as a fair one for the people of Trimdon Village.  He referred to a letter sent to all residents from the Skerne Medical Group about the difficulties that it was facing for all four sites, but then went on to say that Trimdon Village could not stay open from February 2019.  He added that three public meetings had been arranged but were not included within the letter and people had to find out by viewing the website.  He was frustrated about this as not everyone had access to a computer.  With regards to the Trimdon site he reported that there had been many opportunities to extend the site.  The area had high deprivation, medical needs with many single parents, elderly and vulnerable patients and felt that this decision was being made for financial reasons.  He understood that there were plans for a new surgery at Wynyard and asked if the Skerne Medical Group had been asked to provide this.  He asked that Trimdon Village remain open and be included in the full review.

 

Councillor Wilkes asked if the practice had calculated how many more home visits they would have to carry out in Trimdon Village if people could not get to the nearest surgery as this was likely to impact further on GPs time and costs.

 

The Chairman asked Skerne Medical Group to consider including all sites including Trimdon Village.

 

Dr Hearmon said that all GPs want to provide safe medical care and the position of being able to do this due to a diminished pool across the area had led to an engagement process.  They needed to make a decision on the best way to do this with the team available.  She assured Members that there was no truth in the move to Wynyard and that they would absolutely not be providing a service there.  They had already made provisions for the costs of home visits and had added clinical practitioners and a paramedic to help provide that service. 

 

Resolved:

(i)         That the information provided by Dr Hearmon be noted and a further update from the Skerne Medical Group in respect of the preliminary patient and stakeholder engagement be provided to the Committee at its meeting scheduled for 4 December 2018.

(ii)        That the establishment of a cross party working group to review GP services across County Durham be agreed.

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