Proposals for three GP ‘practice groupings’ in Thanet, each serving between 30,000 and 60,000 patients, have been confirmed by health bosses.
The initiative is part of the Sustainability and Transformation Plan (STP), created by Kent and Medway health trusts, the NHS, Kent County Council and Medway Council, which sets out proposals to overhaul the health system, including changes to GP surgeries and hospitals.
The STP says extended GP practices will provide enhanced in-hours primary care and enable more evening and weekend appointments and hubs – with an even greater patient capacity – will offer multi-disciplinary teams delivering physical and mental health services locally at greater scale and seven day integrated health and social care.
Original proposals were for four GP groupings – dubbed Primary Care Houses (PCHs) – made up of ‘Quex’ (comprising the villages not the estate), Broadstairs; Margate and Ramsgate.
New proposals reduce that to three by combining the villages and Broadstairs.
Thanet Clinical Commissioning Group, which plans and buys healthcare services for the residents on the isle, says some £16.5 million will be spent creating the PCH services.
The details for the three localities are still in development but at present the proposal is:
Margate
A £6.5 million extension to Bethesda Medical Practice in Cliftonville, so it can provide GP services for around 29,000 people This will grow to 32,000 as the population rises over the next five years.
Due to open in 2020, the new facility will provide the usual GP/nurse services, plus a range of other services currently only available in hospital. There will be a multipurpose education room, a community café and a base for other NHS and care professionals. It will also be used as a place where people can go to get information and advice on living a healthy life.
Plans for Bethesda were put on display at a drop in event on January 10.
There are currently two plans for the new build, funded by a successful NHS bid. One will be chosen and submitted as part of a formal planning application.
The centre is hoping to buy the old coach park next door to provide additional parking. Currently plans show spaces for 40 vehicles.
A merger with Northdown surgery is expected to take place when the improved centre is completed. Meetings are currently taking place to look at dual working. Once the merger is complete there will be one team. No redundancies are expected.
Westwood/Quex (Broadstairs and villages)
A new £10 million health centre to be created at Westwood Cross, hosting GPs and a range of other health and care services for some 60,000 patients. Broadstairs will be working together with Quex in Birchington as a PCH offering mutual support but Thanet CCG say this is not a structural or physical move.
Ramsgate
The third hub is the Montefiore Medical Centre (described as East Cliff by the CCG) in Ramsgate. The aim is to have all the staff trained in helping patients find support from One You Kent to help them improve their health. The practice also offers health walks, carers’ support, and is working with Social Enterprise Kent to enable patients who are looking to get into work to get extra support.
Isle practices
Currently there are 14 GP practices on the isle, Thanet CCG says there are no plans to reduce those surgeries. In the case of Bethesda GPs are likely to merge the Northdown service at the extended site. The CCG say the Westwood plans are at an early stage but it is likely some practices across the area will merge and deliver all their services from the new building, others may deliver some services from Westwood and some from their current buildings and others may want to keep all services at their current site but work closely with the Westwood teams. The same options would apply for Ramsgate and the Montefiore centre.
The CCG spokeman said feasibility studies were being carried out and any impact on patients would be thoroughly assessed.
They added: “The CCG contracts with the surgeries which are independent businesses. They respond to the pressures they find themselves in. Work force shortages and other factors are making surgeries review their working practices and, as we have seen the loss of all Thanet’s single GP practices, there may be further changes.
“There is no further information at this stage about individual surgeries.”
Each of Thanet’s current practices serves an average of 8,500 patients.
‘National initiative’
A spokesman for Thanet CCG said: “In Thanet, GP practices are coming together in three local areas to improve the care they can offer patients. This is part of a national initiative aimed at creating an integrated and sustainable approach to care and improving services for patients. There are no plans to reduce GP surgeries.
“We are very lucky in Thanet to have a group of GPs who, in the face of the challenges of a shortage of health professionals and increasing need for services are leading the way in developing new and innovative ways to provide the right services to people across Thanet. We hope this innovation will be attractive to GPs wanting to work here.
“The three local areas are in Margate, Ramsgate, and Broadstairs and villages. Each has a team which includes staff from mental health, social care and voluntary organisations as well as the medical staff.
“These developments are all part of Thanet’s Strategy for providing health and care into the future, meeting the challenges currently being faced in delivering health care across East Kent and indeed nationally.
“These challenges include a growing demand for care due to an increasing population and people living longer, too much focus on treating ill health rather than preventing it, and issues with the way healthcare is organised such as fragmentation and difficulties recruiting skilled staff.”
GP vacancies
According to the STP: “There are very high levels of vacancies across primary care in Kent and Medway, with an estimated 136 GP vacancies across the area (12% of the total number of GPs), and 53% have been vacant for more than a year.
“This creates a dependency on locum GPs – on average locum doctors constitute 8% of the GP workforce in Kent and Medway. The situation is likely to get worse as 30% of GPs in the area are aged 55 and over and are therefore expected to retire in the next 10 years . This is compared to 22% nationally.
“Furthermore, there are challenges in recruiting practice nurses; every single one of the vacancies reported in a recent survey of practices been open for more than 6 months.”
The CCG says benefits of the proposal will include better integration between community health and social care based on a single point of access around GP practices. Multi-disciplinary teams will work alongside each other to improve patient care and those patients will have access to more care services without having to go to hospital.
The CCG also says having teams of different specialists working together will reduce costly duplication of services.
Concerns
Labour Group Leader Jenny Matterface said there are concerns over the hub proposals.
She said: “I have serious concerns over plans to reduce the number of GP surgeries in Thanet and feel residents need to be aware of what is proposed. Already a number of small surgeries have closed due to retirement of the doctor and haven’t been replaced putting even more pressure on the remainder.
“A large number of our GPs are over 50 and will want to retire soon so we need a robust policy of recruitment but is creating extended surgeries the answer in an area of low car ownership?
“Too many residents would have a difficult and expensive journey to see their GP if this plan goes ahead. Whilst the extended surgeries can offer far more services they would be of little benefit if those in need can’t easily access them.
“Any plan to make major changes needs some joined-up thinking to ensure the surgeries are within easy reach of patients.”
Save Our NHS meeting
The proposals, along with those that have been outlined for A&E services in east Kent, will be discussed by NHS campaigners at a meeting in Broadstairs this month.
The Save Our NHS event will be held at the Queens Road Baptist Church in Broadstairs on January 27 from 10.30am until 3pm.
It will be hosted by Thanet Trades Union Council.
The programme for the day:
11.00-11.45 Opening session: Rosie Duffield MP, Dr Bob Gill, Dr. Coral Jones, Cllr Karen Constantine, Jacqui Berry (Health Campaigns Together and Unison executive) Green Party health spokesperson Larry Sanders
11.45-12.30 Workshop: Sustainability and Transformation Plans: What are they? With Dr. Bob Gill and Ken Rogers (Concern for Health in East Kent)
12.30-1.00 Lunch break/networking
1.00-1.45 Workshop: Mental Health – with Jane Hetherington and Dr. Dick Symonds
1.45-2.30 Feedback and questions session with Dr. Andrew Paul Thompson and others.
