“We got a letter at the end of 2014 signalling that our budget was going to be decimated, that we were going to be losing almost 44% of our budget,” says Dr Paul Wilding as he sits with First Practice Management (FPM) Group to talk about the extensive cuts to funding at Slaithwaite Health Centre.
Slaithwaite Health Centre is just one of many PMS GP surgeries facing funding cuts and being threatened with extinction as a result. The GP Partner has seen the health centre go from rags to riches since he has been there, with the surgery now being considered one of the best in the area.
However severe cuts have put all of that into turmoil, with Dr Wilding admitting that the proposed cuts mean they are ‘not survivable.’
Like many of the other practices we have spoken to in similar situations, the NHS have not consulted with the practices and are not responding to correspondence. NHS’ response in the media has been that no cuts have yet been made.
In response to the news, staff at Slaithwaite Health Centre have done their best to maintain the high standard of care they deliver. Operational Manager Kelda Childs explains the strain that the news puts on staff as well as patients;
“Everybody is really worried about the future, what the future might hold. Not just for the patients who we have come to love and know really well, but what’s also going to happen in terms of employment, their future and their jobs.”
Staff are carrying on as usual for the patients, but soon the level of care they can give could be out of their control. Dawn Fretwell (Nurse Practitioner) tells us, “We work hard as a team and we try to provide the best care possible within the resources we have, but if those resources are going to be depleted that obviously has an effect on the care we are able to give. Patients are upset and unhappy and obviously wanting to do something about it - we have a lot of proactive patients who are out there campaigning”.
Pat Jones is one of the patients who has been campaigning on behalf of the practice since the news broke, and her family have been patients at Slaithwaite Health Centre since it opened. She got involved with the patient consultative group after hearing about the proposals. Recovering from the shock, the group first made a banner which has become the mascot of future campaigns and have since held public meetings and a ‘knit your own GP’ day for patients to show their support and bolster awareness in the local community.
Pat and some of the other patients have taken a petition to Local Conservative MP, Jason McCartney’s surgery. One patient has even sought legal advice regarding the situation and is now taking legal proceedings.
On the effect that closures would have on the surgery, Pat believes it will prevent people getting the care they need;
“The GPs here are sensitive to the patients and the area itself. They understand the demography of the area and I think a lot of people will no longer go to the GP when they want to as they don’t feel comfortable. This is a very accessible surgery - physically and emotionally, people feel safe coming here.
“If the GP surgery closes that puts pressure on the A&E – if the A&E closes that puts more pressure on the GPs.”
On 17th March, the surgery’s patient campaign group Slawit Health Centre SOS delivered a motion of no confidence to bosses of Calderdale and Greater Huddersfield CCGs, as well as NHS England, arguing that no public service can apply such massive cuts without forcing the surgery to radically transform the service, or forcing the practice to shut down because it simply can’t deliver a safe service.
Kathryn Hilliam, head of co-commissioning at NHS England West Yorkshire, has previously said: ‘Slaithwaite Health Centre ... is one of the higher funded practices in an area with low levels of deprivation when compared to other practices which have significantly challenging health needs.”
Paul says “The statements that have been issued to the press about our plight are in response to our patients support group who are generating headlines of their own. We were described, as a community, effectively as a ‘leafy shire’ with no particular deprivation or extreme health needs. It’s not for me as a GP - when I visit social housing, vulnerable elderly people, troubled families, lonely folk with mental health disorders, drug addiction, alcoholism and a disproportionate amount of child safeguarding issues.”
In this town alone, there is a wider crisis at hand - alongside the PMS reviews affecting 60% of GP Practices and ongoing plans to downgrade Dewsbury District Hospital services, the CCG’s ‘Right Care, Right Time, Right Place’ proposal revealed plans to close the Huddersfield A&E service and move it to Calderdale Hospital. This has faced widespread condemnation from the population, who organised a campaign with their local press culminating in a protest march attracting over 5,000 members of the public. Kirklees Council held a meeting last week opposing the proposal, calling for a more workable solution.
As Dr Wilding explains, the problem is bigger than just Slaithwaite surgery though - 22 of the 38 practices in Huddersfield are facing cuts. “The practices in Huddersfield affected are a symptom of a greater malaise around a lack of political honesty, and I blame all the parties for that.” The University Health Centre in Huddersfield is one of those facing extreme cuts to their budget. We also spoke to one of the Partners and the Operations Manager at this particular practice, whose story we will be exploring on the FPM blog next week.
“There is a lack of honesty about how desperate things are and the failure to anticipate what was entirely predictable, that the health service in its current form would not sustain the relentless increase and escalation in needs and cost which was inevitable with the population changes.”
The national impact this will have on the provision of GP care is demonstrated by the numbers involved - PMS practices could face up to £260m of their funding being withdrawn and reallocated, with NHS England telling Local Area Teams to “secure best value” from PMS contract funding that is not linked to additional services or agreed KPIs. Comparing the PMS premiums by Areas, West Yorkshire gets less than £29m while London South receives nearly £42m.
“The contracts appear to have been phased in, and I get the feeling that they have left London till last – certainly it’s happening now and they are beginning to have contract meetings. I hope some of the London Practice Managers and GPs get in touch – I’m sure we and others would be happy to share our experience and some of the communications and resource networks we have built to support each other.”
Keep an eye out for next week’s post on The University Health Centre, Huddersfield, where we discuss the severe funding cuts the practice is facing.