Three communities nationally have rallied to separate GP SOS (Save Our Surgeries) calls in the last 16 months. They are a formidable opposition to the devastating GP funding cuts being meted out by the government and NHS England. Meanwhile, other GP practices have triggered avalanches of support merely by going public about the funding carve-up.
Save Our Surgeries: east London
The Save Our Surgeries Campaign in east London was launched in April 2014 in response to the announcement of cuts to the Minimum Practice Income Guarantee (MPIG). NHS England itself admitted that the cuts would make 22 east London practices financially unviable, but in reality, this number was a serious underestimate.
The campaign involved GPs, practice staff, patients, trade unionists and health campaigners. It included two demonstrations, the presentation of a 140,000-signature petition to Downing Street and the securing of support from 12 London Labour MPs, as well as the health scrutiny boards of the London boroughs of Hackney, Newham and Tower Hamlets.
In addition, a local patient made a successful legal challenge using the 2006 NHS Act which requires that patients be consulted about all significant changes to NHS provision. We believe that this ruling should apply to any future decisions made by NHSE.
Researchers linked to the campaign also presented evidence to NHS England chief executive Simon Stevens and health secretary Jeremy Hunt showing the link between deprivation, ill health and GP consultation rates. The review of the funding formula for general practice later took this evidence into account.
NHS England finally admitted the existence of a ‘headroom budget’ for emergencies in primary care. This funding is available to any CCG with full delegated commissioning responsibility, and elsewhere to any practice through their NHSE Area Team. By accessing this budget, SOS in east London has so far secured the funding to reprieve 11 practices in Tower Hamlets.
Page Hall – Sheffield
Page Hall Medical Centre in Sheffield is based in one of the most deprived wards in the UK. Over the last 20 years it has adapted primary care services to meet the needs of an exceptionally disadvantaged community. However, it now faces a 21% cut in funding, to be phased in over the next three years, as a result of the abolition of PMS contracts.
In July, patients rallied at an emergency practice meeting so large that it spilled out into the car park, and urges the local CCG to take their needs into account. Pleas made by the campaign to the ‘Parliamentary Health Committee Inquiry into Primary Care’ led to a visit to the practice in November, where other GP leaders from across England were also able to impress upon the five MPs the pressures surgeries across the country were facing.
Following negotiations with their commissioners through a ‘special cases’ submission process, the Page Hall practice has secured the offer of cross-practice local commissioning scheme funding to meet the specific needs of their community for a minimum of two years, starting in April 2016. The details and figures are still being finalised.
Family Doctor SOS: West Yorkshire and beyond
NHS England’s PMS ‘equitable funding’ shambles will hit West Yorkshire particularly hard. Nationally, 40% of practices receive PMS funding, but in the Huddersfield area this rises to 60%. At least two practices in the area are particularly badly hit: Slaithwaite Health Centre, which expects to lose 44% of its funding and the large Huddersfield University Practice, which faces a 33% budget cut. Both practices are convinced that they will be forced to close if the funding cuts go ahead.
The GP partners at Slaithwaite Health Centre in Huddersfield opposed the draconian PMS cuts right from the start. The Family Doctor SOS campaign is a response to the carnage they can see unfolding among local GP practices.
The campaign offers multimedia support - via the FamilyDoctorSOS.co.uk website, the #FamilyDoctorSOS hashtag on Twitter and a Facebook page to practices facing extinction nationally. The website’s home page includes an interactive map, where surgeries across the country are now declaring ‘SOS’. The media campaign has attracted press, radio and TV coverage – nationally, regionally and locally.
A patient-led SOS group has also been set-up. The members are applying local pressure to politicians and NHS England and there is also an ongoing patient-led judicial review application. Both campaigns are aligned to NHS Survival.org which is arguing for a cross-party working group and public debate into taxation levels and the future of the NHS and social care.
Dr Paul Wilding, one of the three GP partners at the Slaithwaite surgery suggests that surgeries threatened with closure consider calling themselves 'A&E centres’ - pointing out that the threat of closure to an A&E department generates panic and calls for emergency bail-outs, but threats to local GP practice closures get virtually no media attention at all.
The common theme in the three campaigns is community action. GPs are the most trusted professional group, while politicians are the least. Your surgery has a hidden army of motivated and talented folk who will come to you in your hour of need. Our key message to surgeries still at the races is sign nothing, go public with your story and contact us for help and advice.
Thirty years ago, David Widgery wrote: 'In this imperfect and worsening world we desperately need our doctors, our hospitals, our nurses, our ancillaries. We need them to be given the finances to use their skills to the full. The cuts must be stopped and spending increased to a level at which the NHS can function properly again. Unless this is done, decline, disillusionment and a multitude of private tragedies will continue. Until it is done, we – we health workers, patients and citizens – must raise our levels of dissent.'
He wrote this in The National Health Service – a radical perspective, in 1988. In 2016, our patients can see that his analysis still applies, and they know that action speaks even louder than words.
The authors of this article are Yorkshire GP Dr Paul Wilding, London practice manager Maggie Falshaw, London GP Dr Naomi Beer and Sheffield GP Dr Kate Bellingham. To contact them, email FamilyDoctorSOS@gmail.com