Exclusive: NHS England backs down over list closure breach notice

NHS England has backed down from a threatened contract breach notice after a practice closed its list to protect patient services.

Dr Tracey Vell: boundary solution (Photo: JH Lancy)
Dr Tracey Vell: boundary solution (Photo: JH Lancy)

Chief executive Simon Stevens has said the application of rules on practice list closures is being discussed.

An unnamed Manchester practice took informal action to stop taking new patients after a neighbouring GP retired and his list was dispersed by commissioners.

Understaffed local practices expected to pick up new patients said they could not manage increased demand.

Practice boundary solution

The unnamed practice requested permission from NHS England to either reduce its boundary or formally close its list and was denied permission.

Following GPC guidance, the practice temporarily closed its list to protect patients but, according to Greater Manchester LMC, received written communication from NHS England informing them of a possible breach of contract.

GPC workload guidance issued in January told practices they are allowed within the terms of their contract to take ‘informal list measures’ to decline to register new patients.

The guidance said practices can decide not to register new patients, provided they have 'reasonable and non-discriminatory grounds for doing so', (such as protecting the quality of patient services). 'In such cases, the regulations allow practices to refuse to register new patients,’ the GPC advice said.

Local commissioners have now backed down. Greater Manchester LMC chairwoman Dr Tracey Vell said: ‘We met with NHS North as the practice had been declined a boundary change or closure. During the meeting we resolved the situation with a boundary change being a satisfactory solution after which time the practice list will re-open.’

Breach notice threat

Dryland Surgery in Kettering, Northamptonshire, was also threatened with a breach notice after it stopped taking new patients because GPs feared patient safety was at risk.

New guidance issued by NHS England earlier this month said that ‘a temporary halt to new patient registration is appropriate’ when urgent action is required because of ‘a sudden impact on a practice’s ability to provide patient services’.

Mr Stevens told GP the rules had not changed and need to be adhered to. ‘Nothing has changed about the rules,' he said. ‘How they are applied, I'm sure that is the conversation that is taking place.'

Mr Stevens added: ‘We also have to expand the investment in general practice to relieve the pressures practices are facing.’

A spokesperson for NHS England North (Lancashire and Greater Manchester) said: ‘We have met with the practice concerned on a number of occasions and will continue to support them along with Manchester LMC regarding their and their colleagues' concerns.

‘Communication between the practice and NHS England have been open and as comprehensive as possible. We have offered to support the practice regarding their concerns and strategically plan their patient services.

'In accordance with these strategic discussions, NHS England is expecting the practice to be re-presenting a request regarding its practice registration boundaries to manage its lists and support patient access in the future. It is not our intention to issue any contract breach notices but to work with our providers and resolve any issues relating to local services and contractual delivery.’

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