NHS trust pulls plug on two GP practices after £500,000 losses

Two practices in central London serving thousands of patients could be closed after the NHS trust that runs them gave notice on its contracts after losing more than half a million pounds on the service last year.

Dr Tony Grewal: APMS contracts have posed challenges (Photo: Nathan Clarke)
Dr Tony Grewal: APMS contracts have posed challenges (Photo: Nathan Clarke)

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

LMC leaders are working with NHS England to ensure services continue for patients, although NHS England said it had made no decision as yet about the future of the services. It has launched a consultation with residents and its officials are assessing the viability of either re-procuring the contracts or dispersing patients.

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

Board papers from the trust’s finance committee show there were concerns over the GP services' ‘negative contribution’.

Losses over £500,000

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

The costs were ‘largely due to locum and other temporary staffing costs’, the meeting was told.

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

In March trust deputy chief executive Richard Milner presented data that ‘highlighted the legacy of the Soho Square and Milne House GP practices, income and expenditure overview, staffing levels and recommendations for 2014/15’.

A spokesman for the trust said the temporary staffing costs were incurred by two maternity covers at Milne House.

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

Londonwide LMCs medical director Dr Tony Grewal said while he was not familiar with the details of the CLCH practices, in general APMS contracts often made it difficult to provide services to the required standard.

APMS deals challenging

‘It is actually quite hard to deliver the services to the quality required for the funding that is there for many APMS practices, and I am aware that particularly where outside organisations have come in, it has often proved difficult for them,’ he told GP.

‘There are examples where they haven't succeeded across London,' he added. ‘The funding is very tight and the temptation to underbid to try and get the contract is strong, because it is commercial pressure for delivering something which is not strictly a commercial service.’  

The situation has been exacerbated by a third practice in the area closing. A retiring single-handed GP close to Milne House has given her three-month retirement notice and is selling the practice premises.

Dr Grewal said the LMC was working with NHS England to find a way to ensure the services currently provided by CLCH continue in some form.

‘We believe that continuing practice there in some form or another will be beneficial to patients, and we know doctors there have put a lot of work into it,' he said. ‘We are working with NHS England because, on this occasion, they feel that those practices disappearing and dispersal of those patients might not necessarily be in the patients’ best interests.’

Patients could be dispersed

A spokesman for NHS England London said: ‘We are looking at existing GP services in the area, to establish the viability of either re-procuring the contracts or dispersing the patient list, and reinvesting into existing primary care services.

‘NHS England (London) has made no formal decision about the future of these services.’

A CLCH spokesman said: ‘As part of our routine business planning, we have decided that we no longer wish to provide this service and we have, therefore, given notice, as required.

He added: ‘This is because running GP services does not fit with our strategy to lead out-of-hospital community healthcare and develop high quality and innovative community services.’

‘We are working with NHS England to give them every support in managing a smooth transition to a new provider.’

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