Practice set to close as NHS trust pulls plug

NHS England has said it will not reprocure a central London practice after an NHS trust provider pulled the plug on the service.

NHS: Trust pulls plug on GP practice after cash losses
NHS: Trust pulls plug on GP practice after cash losses

Milne House Medical Centre is one of two practices run by the Central London Community Healthcare (CLCH) NHS Trust that faced closure. The trust decided in July to hand back contracts for the practices after facing financial losses.

Following a consultation, NHS England London said in August it would reprocure the other practice, Soho Square, which operates under a PMS contract. But the consultation for Milne House, run under an APMS contract, was extended after some patients did not receive letters.

NHS England London has now said CLCH will stop providing services at Milne House on 31 October, after which patients will be dispersed.

Opaque decision-making

HealthWatch Central West London (CWL) criticised NHS England’s 'opaque' decision-making, saying it failed to notify some patients and gave out contradictory information.

A spokeswoman for NHS England London said: ‘We carried out an engagement programme with the patients and stakeholders of the practice to look at future options. During this time we listened to the views of patients and local residents, as well as reviewing existing GP services in the area and the health needs of the local community.

‘Following the engagement, we have made the decision to disperse the patient list of Milne House Medical Centre. There are 14 neighbouring practices, all within one mile of Milne House Medical Centre, who have capacity and are able to accept these patients. Staff at these practices will be on hand to support patients through the registration process and we will be offering additional help to vulnerable patients.’

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 significant financial losses.

Losses exceed £500,000

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. 

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.

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