Healthwatch Sefton response to Hightown Village Surgery decision

There has been considerable coverage of the decision to close Hightown Village Surgery after NHS England (Merseyside and Cheshire) could not  secure a new provider despite a lengthy consultation process.

The following is a letter sent from Healthwatch Sefton in response to this decision.

Re: Outcome from the procurement exercise for Hightown Village Surgery.

Thank you for your letter (dated 28^th February 2018) sharing the outcome of the procurement exercise for Freshfield Surgery, Formby and Hightown Village Surgery, Hightown.

The process undertaken by NHS England (Cheshire & Merseyside) and NHS Southport and Formby and NHS South Sefton Clinical Commissioning Group to listen to patients during the Listening Events held during 2017 were transparent and exhaustive. However as a key stakeholder we are disappointed that there was not any meaningful dialogue with the community and ourselves prior to letters being sent out to the patients of Hightown Village Surgery, especially as we supported the initial work via the task and finish group alongside the surgeries Patient Participation Group.

Healthwatch Sefton has a number of concerns/areas of further clarification which we share within this letter.

We would be interested to find out the reasons why the interested provider for Hightown Village Surgery withdrew their bid, and at what point in the process, but understand that there may be legal reasons why this information cannot be divulged.

Given a decision has been made to transfer patients to other GP practices; we have a number of concerns relating to the capacity of current practices in the Crosby and Formby localities.

From referrals to the Healthwatch Sefton Signposting and Information Service, we are aware that GP practice lists in the Crosby locality have been informally closed for some time due to a historical issue with a previous provider.

We are also aware that work has been ongoing with the practices in the locality and that from 1^st April 2018 lists will be reopened to all patients. If the 2000 patients from Hightown are to be transferred to practices in the Crosby locality, we would be concerned about the impact and pressures this would place on current practice lists and the impact on appointment availability for current and new patients.

Within the letter you share that patients will be allocated to a GP practice close to where they live and that if they do not wish to transfer to the one allocated, they can choose to register with a different GP practice. With limited capacity how will this work? Patient choice will certainly be limited given current capacity issues.

Our concern about the transfer of patients to practices within the Formby locality is, again, the impact of over 2000 patients adding to already overstretched patient list sizes, in buildings with limited space. We have previously had discussions about the impact to GP patient lists within the locality given the projected increase in population of Formby with approximately 900 – 1000 new houses being built and two new 75 bed nursing homes. With the transfer of patients from Hightown Surgery, this will put an increased pressure onto Formby GP practices.

In addition, we are aware of the agreement for 130 new houses to be built in the Hightown area and ask if this has been added into the future planning needs for primary care in Sefton.

Other issues which need to be considered which were also raised by patients during the listening exercise include the geography of the area.

Hightown has poor public transport links, being geographically isolated with an elderly demographic.

Prior to the decision being made about the closure of the surgery and the transfer of patients we would like to know if there were any considerations which would act as a compromise in supporting patients to access primary care in the Hightown area.

Was there any consideration that Hightown Village Surgery be utilised as a branch surgery of a current provider, with a sessional service for patients who are vulnerable/ lack mobility? Have any proactive and innovative solutions been considered, for example the use of technology?

In the decision to close the surgery and transfer patients, has there been any consideration of looking at the provision of improved transport during surgery times/ discussions with Mersey Travel?

With the decision to close Hightown Village Surgery, local residents will be left with no service within the immediate area. The local pharmacy does not provide ‘Care at the Chemist’. Another concern which Healthwatch Sefton has raised with both NHS Southport & Formby CCG and NHS South Sefton CCG is the impact of the process for ordering repeat prescriptions for vulnerable patients.

According to NHS Choices, under 30% of the patients registered at Hightown Village Surgery are signed up to the online booking service/ ordering of repeat prescriptions. With patients being transferred to other practices and the lack of transport, Healthwatch concerns about repeat prescription ordering are heightened.

We are aware that we are not the only organisation to have raised concerns and, having two seats on the Overview and Scrutiny Committee for Adult Social Care and Health, will be in attendance at the meeting which is being convened for the 22^nd March. We have sent a copy of this letter to the Chair of the committee so they are aware ahead of the meeting of the issues being raised by Healthwatch Sefton.

We would welcome your response to this letter within the statutory 20 working day timeframe (Health and Social Care Act, 2012).