Letter to Alison Smith CCG – 20th November 2019

Brading Residents’ Association

18 Quay Lane,

Brading. PO36 0AT

20th November 2019

Alison Smith

MD, IW CCG

Building A, The Apex

St Cross Business Park

Newport.

 IOW. PO30 5XW

Dear Alison Smith,

BEECH GROVE SURGERY CLOSURES

Brading Residents’ Association, appreciate how difficult this situation is for the CCG, but in the meantime request that the CCG consider the difficulties patients and residents experience who reside in Brading with the proposed change.

Difficulties mainly being age, low incomes, and the size of this undulating geographic area, with its far reaching boundaries, which include rural lanes and roads, situated well away from main transport routes, Even within the hub of the town, access to main routes can often be hilly and quite long. Hardly any routes in Brading are totally flat and close to transport routes.

Inequality – Below are just a few examples, of how unfair the Beech Grove closure is for patients, and enshrined within the NHS constitution are statements,  which bears no resemblance to what is being expected of us,  to accept,  and experience.

We request that you will be open and understanding of all the difficulties patients will experience in accessing healthcare outside of the Brading area, and are a contradiction of many statements and proposals made by, and within the NHS.

In our letter to Tracy Savage recently, we detailed many of our concerns,  and  ask that these should be revisited.

The NHS Constitution sets out rights to which patients, public and staff are entitled,  and pledges to ensure that the NHS operates fairly and effectively, that all NHS bodies, private and voluntary sector providers are required by law to take account of this Constitution in their decisions and actions.

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The NHS provides a comprehensive service, available to all. It has a duty to each and every individual that it serves and must respect their human rights

 A patient will be at the heart of everything the NHS does – It should support individuals to promote and manage their own health

The NHS is accountable to the public, communities and patients it serves. The system of responsibility and accountability for taking decisions in the NHS should be transparent and clear to the public, patients and staff

Working together for patients –we put the needs of patients and communities before organisational boundaries. We speak up when things go wrong.

Everyone counts- We maximise our resources for the benefit of the whole community, and make sure nobody is excluded, discriminated against or left behind

NHS pledges

  • Make decisions in a clear and transparent way, so that patients and the public can understand how services are planned and delivered
  • Make the transition as smooth as possible when you are referred between services, and to put you, your family and carers at the centre of decisions that affect you or them.

Informed choice – your rights

  • You have the right to choose your GP practice, and to be accepted by that practice unless there are reasonable grounds to refuse, in which case you will be informed of those reasons.
  • You have the right to express a preference for using a particular doctor within your GP practice, and for the practice to try and comply

Even though you have tried to engage with patients, the overall feeling is that meetings could have been better structured, and this has led to concerns, and a lack of confidence and that of no clarity, with a worry that the transfer of records and prescriptions will not go smoothly.

There was disappointment that only 3 options were considered, that the public had no say in the matter whatsoever, with the survey balanced in a way it gave the answers you desired. There was no clarity within the survey, which should have the patients needs at its pinnacle, it is just a demographic exercise.

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We are pleased , (although it was not the CCG who engaged as stated) that the petition,  has  been fed into your engagement report.  This has only been partly submitted, to meet initially with the closing date of the survey. We have extended it.

It is hoped that it is still a consideration, as people signed under the understanding that we are asking the CCG to agree to the provision of GP services and a Pharmacy within Brading.   

There has been no given timescales for our GP relocation, no confirmation with  regards timescale for  re- registering, should you be unhappy with your allocated surgery,   so people are very rightly concerned.

There is no understanding to what the ‘overall process’ is going to be. It is felt that any rights patients may have had in the decision making process, have been over ridden by the CCG making the decisions on their behalf, rightly or wrongly.

There is already evidence of problems at Beech Grove Brading, with appointments being cancelled.

Can we be reassured that we have continuity of care and service before and after transfer?  Beech Grove staff will leave, or go off sick in the meantime.  Staff will naturally be seeking new jobs, perhaps there may be no staff left by March?

In other areas on the island, where there have been closures, Ryde and Yarmouth for example, the impact has been lessened as they have a Pharmacy to help with the minor ailments and advice. Yarmouth consists of lots of holiday homes,  so pressure on a GP surgery out of season will  be far less than for the likes of Brading which is all year round, so cannot be used as a comparison when judging previous closures.

Brading has been denied any chance of equal opportunity, because of the previous refusal of a Pharmacy.  Brading for many years had a Chemist, situated at the Bull Ring and was called Smith’s, so there has been has been a need in the past,  at a time when the housing stock was far less.

NHS LONG TERM PLAN

The statements below clearly distinguish the inequality in this situation, especially if you take Chapter 2 of the NHS Long term Plan into consideration.

Simon Stevens in the NHS video at the launch of the The Long Term Plan  quotes ‘changes, some are happening somewhere, but needs to be everywhere’ this is not the positive outcome for Brading,  rather the opposite.

Imelda Redmond National Healthwatch –  states ‘what will patients get out of NHS long Term Plan,  will mean more services closer to peoples homes’

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The NHS Long term Plan  – Chapter OneThat people get help more easily, and they can get care close to where they live when they need it.

Supporting GP practices to offer more services nearer to where people live

Chapter Two – , We want to get better at helping people stay well. We also want to make sure that people’s health isn’t worse because of things like

  • Where they live
  • What services and treatments they can get
  • not having much money

To do this the NHS will look where money is needed most and work with NHS organisations to make sure local services are helping to make this better

We will use the extra money to make sure the NHS works well in the future.

These will include

  • Spending more money on services in the community
  • working with local NHS services to use this plan well

Integrated Care systems

  • The NHS will start setting up ways for NHS organisation and local councils to work closer together to make health and care better for everyone.

Nice Medicine Optimisation Quality Standard state, that one quarter of the population has a long term condition. One quarter of people over 60 have two or more long term conditions. The use of medicines is increasing.

What we will do – There will be more funding for health services in local communities £4.5 billion a year extra by 2023/24. There will be more Healthcare staff working in and with GP practices.

Starting Well. Reduce A & E attendance from children by improving children’s health services, to get support to stay well.

We are asking the CCG to consider all the statements above, and realistically reflect that even with the transfer to other GP surgeries; can any of those statements be a true portrayal of equality of service for Brading residents? By denying us access to services in our own town is against the ethos of those statements.

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As we have previously highlighted in our correspondence to Tracy Savage,  our concerns with regards time, cost and difficult travel options which will be long and arduous for many patients to travel to outside area practices.

Parking will be an issue, the amount of blue badges holders transferring will impact on the few disabled bays available.

Appointment times could be even longer for patients at the accommodating practices, patients already experience a four to six week wait for an appointment with their GP. Add another 4.500 + into the equation is bound to have an impact on appointment times.

There is a need for complete transparency in this situation, the statements that the CCG has not had time to plan, is only a small part of the bigger picture. The Primary Care Strategy and the NHS Long term plan, clearly does not support smaller surgeries, with aspirations of bigger is better!  Long term it may be, but at what cost in the interim?

PCS 2017/2022Patient and Public Engagement –  states

  • develop a wider communications programme to support this transformation programme which ensure that the CCG is taking notice of what patients want and need to know, this includes
  • Being honest about our intentions and brave in the way we communicate
  • celebrate what is good in primary care
  • provide a clear explanation of how services will be delivered

We sincerely hope the aspirations of the ‘localities’ will not be at the cost to patients   wellbeing, cause hardship and inconvenience, and will  be experienced  by a high proportion of elderly and low income families. There were many comments and anger from those attending the meeting when we were told the chosen option,  stating ‘they are not listening to us!’

We maintain that patient capabilities of moving practice, must be of the utmost importance and consideration.

Rather than making decisions on demographics alone, there is a need to identify abilities, of time taken to travel, and the costs, as this will be just too much for some.

Without such evidence in place, placements will be unfair and could result in increased levels of sickness levels and hardship, not to mention any safeguarding issues, and putting more pressures on services already unable to cope.

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It is incredulous to think, that even where it is stated in the Primary Care Stragetegy 2017/ 2022 that “the number of over 65’s per practice is around 90% higher than the national average.  That this appears not have been a main consideration. This is evidence why many of Brading patients will find it difficult to transfer out of area for many reasons, but mainly by not driving.

We therefore ask, to ensure there is equality for all patients, especially those being relocated, we request that the CCG, along with NHS England, Healthwatch, and other bodies including the IOW Council, (as part of their Health and Wellbeing Stragety for 2018/2021), agree to work together to deliver to Brading a ‘HUB’  to ensure equality for 4.500 patients plus, who have been disadvantaged by the closure of the two Beech Grove surgeries.

Consideration of such, would take the pressure off residents now having to face many difficult issues associated with accessing a GP outside of area.

Having a ‘HUB’ would be a great opportunity to relief pressure that the accommodating practices may experience as a consequence.

A Brading Hub, could be accommodated in any of the properties now available in Brading,  Rectory Mansion for example,  has units  to rent. There are two properties for sale.

Tracy Savage in her correspondence stated,  the CCG supported practices by paying the rent associated with space that is used to deliver NHS services, this money will be saved by the closure of Beechgrove, so  perhaps could be used to support services in a hub?

The hub could accommodate a pharmacy, with consulting rooms,  with space for  visiting GP’s to hold surgeries, and could work on the principle of the CCG’s seven day access.

There is a need to have local access for essential clinics, ie bloods, diabetes etc,  with nurses led clinics,  and could be a base for district nurses, who when having to restock and have to return to the main practice. Perhaps the Health Visitors could return to Brading and hold baby clinic

We request that our comments are seriously considered, and respectfully ask that the CCG address all concerns, and our request for equality, and clarity.

Thanking you in anticipation,

Yours sincerely,

Sue Birch,

Chair Brag, on behalf of the Brag Commitee and membership

cc Tracy Savage

cc Dave Stewart

cc John Metcalfe

cc Brian Tyndall

cc Bob Seely

cc Brading Town Council

  1. Rt Hon Matt Hancock