Practice dropped by NHS trust over £500,000 losses to be re-procured

One of two practices facing closure after an NHS trust provider handed back the contracts will be re-procured, commissioners have said, as internal documents reveal financial problems faced by the surgeries.

The practices will remain open after NHS England London re-procured their contracts (Photo: Jason Heath Lancy)
The practices will remain open after NHS England London re-procured their contracts (Photo: Jason Heath Lancy)

Central London Community Healthcare NHS Trust (CLCH) said last month it no longer wished to run Soho Square and Milne House practices in London and gave notice to NHS England. The trust will stop providing the services from 30 September.

Following a consultation process, NHS England London confirmed it would re-procure Soho Square practice after listening to the views of patients and reviewing local provision.

The consultation period for Milne House practice has been extened following concerns that not all patients recieved letters about the plans.

Soho Square practice is run under a PMS contract, while Milne House is an APMS practice.

Commissioners had been considering an alternative option to close the practices and disperse the patient lists to other practices nearby.

Patients, including from London’s Chinatown, which is served by Chinese-speaking GPs at Soho Square practice, had protested against the threat of closure.

Concerns over losses

CLCH said it was pulling out of the contracts because running GP services did not fit its strategy.

But board papers from the trust’s finance committee showed there were concerns over the GP services' ‘negative contribution’ and half-a-million-pound losses.

A meeting in February heard that losses to date across both practices stood at £515,000, around £256,000 more than planned.

Committee members were ‘concerned about the amount of money being lost through GP services’ and ordered a report into the future of the services.

An internal ‘viability assessment’ presented to the trust’s board in March by deputy chief executive Richard Milner and obtained by GP suggested both practices required ‘substantial’ list size growth to turn around their financial position.

The practices, the report found, were not achieving all potential income from QOF and enhanced services, and were paying above average for salaried GPs. 

Substantial list size growth 'difficult'

With capacity investment, expenditure and a potential reduction of the contract value, both practices would still need to generate additional income through ‘substantial list size growth’.

The report added: ‘The level of list size growth required will however be very difficult to achieve (unless the practices were to absorb another practice's patient list) and as such is not viable to achieve a contribution or EBITDA breakeven position.’

The practices would also need to improve the clinical skills mix, maximise GP productivity, and improve and restructure practice management to become viable, the board report found.

An NHS England London spokesman said: ‘NHS England London undertook an engagement process with local residents which ran for 28 days until 28 July 2014. During this time, we listened to the views of patients and local residents and reviewed existing GP services and the health needs of the local community. The engagement period has now ended, and a decision has been made to re-procure the contract for the practice.

‘No decision was ever made to close Soho Square General Practice. Closure was one of two options, the other being procurement of a new service provider, which was considered after the current provider of the service - Central London Community Healthcare - gave NHS England London six month’s notice to terminate their contract and stop providing these services as part of their business.

‘As a result, the contract for Soho Square General Practice was handed back to NHS England, to review options and make a decision about the future of the practice. This is the usual legal process following the termination of any GP contract.’

He added: ‘Throughout this process, we have made every effort to engage clearly and openly with patients, and will continue to do so. We are aware that some patients were confused by wording in one of the letters we sent out, however we issued follow-up correspondence to clarify this. We also reiterated through public meetings, patient drop-in sessions and media statements that no decision had been taken to close the practice.’

An NHS England London spokeswoman added: 'NHS England (London) has extended the engagement period for Milne House Medical Centre until 19 August 2014, over concerns that some patients did not receive their consultation letters. Following this, a decision will be made about the future of the practice.'

This story was corrected on 19 August 2014 to report that Soho Square practice would be re-procured, and the consultation period extended for Milne House.

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