Health board's concerns over strain on Calderdale GP practices to cope with thousands of extra patients

A healthcare board is concerned about capacity of other practices to cope with thousands of extra patients when provision at some practices ends in the spring,

Calderdale NHS Clinical Commissioning Group (CCG) wants to end services provided by Meadow Dale Group Practice (Virgin Care LLP) at Ovenden, Elland and Sowerby Bridge, and those provided by Park and Calder Community Practice (Locala CIC) at Park Community in Central Halifax and Calder Community in Todmorden, as they are “neither sustainable nor affordable”, according to documents presented to Adults, Health and Social Care Scrutiny Board board members.

NHS Todmorden Health Centre, Halifax Road, Todmorden

NHS Todmorden Health Centre, Halifax Road, Todmorden

The contracts, known as Alternative Provider Medical Service (APMS) contracts, will end in March if this course of action is completed, and this is the option expected to be recommended for determination by CCG members due to meet on January 9.

One more attempt will be made to “test the market” to buy services for patients at Calder Community Practice, which is on the second floor of Todmorden Health Centre, a building it shares with Todmorden Group Practice and some NHS services, from another provider but the backstop option for the CCG, which is legally responsible for ensuring patients will have ongoing access to primary medical services, is to disperse patients among other nearby practices, councillors heard.

Patients have expressed concerns about capacity at other GP practices, about patients returning to practices where they were previously registered, the availability of appointments, travel and transport to practices further away, and about continuity of their care – and these were largely shared by board members.

Coun Colin Hutchinson (Lab, Skircoat) said the paper indicated that compared to North Halifax, for example, the amount of flexibility to disperse patients in Todmorden was less.

“I’m wondering whether you’ve had a response to any expressions of interest and, if not, what plans you have in place to increase availability in Todmorden to disperse these patients?”

Officers responded it was fair to say there had only been a limited response but there were a range of options where access to services could be increased in the town.

Coun Sophie Whittaker (Con, Rastrick) asked for clarification on options of extending existing contracts but was told they had already been extended as long as possible in most cases with, in once case, the provider themselves not wanting to carry on.

She asked for assurances patients dispersed had an improved level of care and officers responded that both Tomdorden Group Practice and Hebden Bridge Group Practice had a

Calderdale-wide reach and active conversations were ongoing about the situation with both. When Coun Whittaker asked if a solution was not found by March would the Todmorden change be delayed, officers replied that a decision would be made in January.

Coun Mike Barnes (Lab, Skircoat) said he had read the report with some horror, particularly considering the March deadline.

“At the end of March a lot of people might not have a GP and that concerns me,” he said. “Do those those other GP practices have the capacity in respect of Todmorden? I think there is an issue here – but at the moment we are not in a position to scrutinise it before they make a decision.”

Officers said overall the affected practices met the needs of around 9,500 people, with around 2,500 affected in the Todmorden area. In the case of Todmorden other practices had given assurances they had more capacity than the number of patients they had registered.

Coun James Baker (Lib Dem, Warley) raised concerns about capacity at Hebden Bridge GP if it took on more patients and Coun Mohammad Naeem said he did not feel assured about the situation. Officers responded that the CCG had a responsibility to ensure every patient in Calderdale had a GP and that is what they would do.

Coun Barnes said: “My main concern is people could be left in Todmorden with a GP, but not the GP they want to have.”

Board chair Coun Howard Blagbrough (Con, Brighouse) said the board should express great concern in relation to Todmorden.

He told the CCG representatives “There are challenging questions, but we need to ask them. We will work with you – and continue to review the effects on the upper valley.”

APMS contracts enable commissioning groups to provide primary medical services within their area to the extent that they consider it necessary to meet all reasonable requirements.

The other routes are General Medical Services (GMS) and Personal Medical Services (PMS).