NHS England criticised for 'opaque' decisions over practice closures

A health watchdog has criticised NHS England for how it conducted a public consultation on the future of three practices facing closure in London, saying it failed to notify some patients and gave out contradictory information.

Practice closures: NHS England criticised (Photo: iStock)
Practice closures: NHS England criticised (Photo: iStock)

HealthWatch Central West London (CWL) said it was 'most disappointed' by the way local commissioners carried out the consultation after an NHS trust said it was handing back two GP contracts.

NHS England has disputed some of the accusations. 

Central London Community Healthcare NHS Trust (CLCH) said in July it no longer wished to run Soho Square and Milne House practices after losing half a million pounds on the services last year. The trust gave notice to NHS England and will stop providing the services from 30 September.

NHS England said either the practices would be closed and patients dispersed, or the services reprocured. 

A third local single-handed practice, West Two Health, is also closing following the GP’s retirement and was also being consulted on. 

Last week, NHS England said Soho Square practice would be reprocured while the consultation for Milne House was extended following problems issuing letters to patients. 

A report published by the local HealthWatch organisation, based on responses from patients, highlighted a catalogue of complaints about the consultation process.

The report said that:

  • Only a small percentage of Milne House patients received letters about the changes

  • Letters for Soho Square practice were sent to the wrong practice

  • The information provided in the letters was confusing

  • CLCH and NHS England gave contradictory information at public consultation events

  • The process for supporting patients to access alternate practices was not clear

  • Consultation information was not available in languages other than English, despite Soho Square serving a large Chinese community

  • Information was not available in formats for patients with learning difficulties or disabilities

  • Decision-making in the process was opaque

The report said: 'Healthwatch CWL has previously escalated our concerns to NHS England about the inaccessibility of the complaints process for primary care. We are now concerned more generally about the quality assurance of general practice. How are patients expected to exercise choice when there is such a lack of transparency?’

It concluded: ‘Overall, Healthwatch CWL is most disappointed by the NHS England approach to patient engagement and communication on these GP closures. In our experience, this process has not been patient-centred and the medium to long-term impact on our residents is unknown.’

A spokeswoman for NHS England London welcomed HealthWatch’s feedback. She said: ‘NHS England London makes every effort to ensure all patients are actively involved in decisions about the future of their health services.

'Along with writing to patients, we held drop-in sessions for Soho Square General Practice, West Two Health and Milne House Medical Centre, where patients could raise concerns or get more information about the consultation process. Patients were invited to voice their opinions online, by post or in person during these meetings or at their practice.

‘We recognise there were issues with the consultation for these practices; for example, some patients did not receive their letters and were confused with the wording of the letters. However, we took several steps to rectify this by issuing further letters offering clarification and holding drop-in sessions for patients to ask further questions.

‘As we know Soho Square General Practice serves a large Chinese community, all patient letters, posters and additional information were translated into two forms of written Chinese and interpreters were available at the public meetings we held.

‘All patients were sent letters when a decision about their practice had been made along with factors that informed that decision. We also gave patients the contact details for NHS England London should they have any further concerns. This letter was again available in two forms of written Chinese for patients of Soho Square General Practice.’

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