What Have We Done to Maintain Services to Patients During the Consultation Period?

What have we done to maintain services to patients during the consultation period?

• Increased dispensary opening hours at Greenmoss Medical Centre

• Increased reception opening hours

• Employed locums to supplement REGULAR GP time

• Introduced Nurse Practitioner appointments for minor illness The benefits of working from one purpose built site:

Increased opening hours Increased services

Increased dispensary opening hours Increased team working

Peer support for staff & GPs Full disabled access

Large free car park with disabled bays No duplication of costs

Staff cover easier to arrange

Survey results

From the survey/consultation letter that went to every household, 582 patients responded. This represents 12% of the overall practice population

The postcodes answering the questionnaire were:

Other How do you currently travel to your GP 1% surgery?

Walk 25%

Public Transport 1% Own Transport Relatives 68% Transport 5% How often do you attend Rode Heath?

Less than once a year 25%

Once or twice a year 31%

Between once a month & twice a year 26%

Between once a week & once a month 18%

Once a week or more 18%

0% 5% 10% 15% 20% 25% 30% 35% Which location do you currently attend when you need to access GP services? 60%

50%

40%

30%

20%

10%

0% Greenmoss Rode Heath Either/both Do you support the practices plan in principle to close the surgery and provide services from Greenmoss Medical Centre?

No 28%

Yes 72% Concerns raised via survey comments 1

Increased home visits for GPs This would continue as the current practice

Lack of public transport to travel to Greenmoss Medical Centre This applies to ALL patients, there is no public transport from Mow Cop etc. Also, it means that if Rode Heath patients can’t get public transport to Scholar Green, the reverse is also true – no transport from Scholar Green to Rode Heath. Also, it must be remembered that the practice is in a semi- rural area and covers approximately 63 square miles, the majority of which does not have good public transport.

Collecting/ordering medication If we were given permission to close Rode Heath Surgery, one option would be to look at offering a delivery service to the housebound. To help ALL patients, would it be an idea to look at putting collection boxes in key areas ie Rode Heath and Mow Cop to help with this? Concerns raised via survey comments 2

Increased waiting times for appointments We have not planned any reduction in appointments if we are granted permission to close Rode Heath Surgery. At the moment however, there are less appointments available with a REGULAR GP as we have not been able to fill the vacancy following Dr Patterson’s retirement. We are using locums to supplement this to maintain the service to patients.

Greenmoss Medical Centre needs to be open more If we were given permission to close Rode Heath Surgery, Greenmoss Medical Centre will be open 8.30am-6.30pm Monday to Friday. This means no closure on a Tuesday and Thursday as at present. The dispensary has already increased its opening hours by 5 per week.

Concerns raised via survey comments 3

Need to replace Dr Patterson ie recruit a new GP We continue to try to recruit another GP. We have spent several thousands of pounds in the past 2 years trying to do this, along side the ‘free’ adverts on local networks, GP Post Graduate Centres etc. We continue to actively recruit, but there is a national shortage of GPs and most practices are finding it hard to fill vacancies.

Letter only sent to household, not individual patients The cost of this was £1550 excluding staff costs. The costs would be more than doubled if sent to each individual patient. The letter and basic survey needed to be sent quickly to patients to inform them of what was happening. The practice thought it would be more prudent to spend the ‘saved’ costs on patient care rather than a letter.

Only 12% of patients responded to the survey. This includes numerous individual responses from several households. Comments from our Patient Panel Group

• If Greenmoss Medical Centre hadn’t been built, the practice would have ceased to exist as the Cinderhill Lane premises were unfit for NHS use. Rode Heath Surgery is now at that stage.

• When Greenmoss Medical Centre was built, the GPs said they would keep Rode Heath Surgery open for as long as they were able despite the former Primary Care Trust recommending its closure. There was never a promise to keep it open forever, this is not feasible in real life.

• Finite resources – the practice has finite resources. We are committed to providing the best service we can within those constraints.

• Extra services are being introduced at Greenmoss Medical Centre. We are working hard to provide services locally to help avoid trips to hospital etc

• We are looking at ways to alleviate the problems caused by the inability to recruit a new GP. We have introduced nurse practitioner appointments and we try to use the same locum GPs as much as possible to provide as much continuity as possible.

Frequently asked questions

• How will you continue to deliver a duty of care at Rode Heath Surgery? • All appointments will be at Greenmoss Medical Centre. There is adequate space, full disabled access and a large carpark. • Transport is going to be an issue for patients - what will the practice do for the patients in Rode Heath Surgery? • Cheshire East Council is currently in consultation with regards to public transport. Perhaps a community group could be formed to liaise with CEC to help them understand the needs of the community. Odd Rode Parish Council also has transport and perhaps they could look at working with the community group. Transport is an issue for all services, not just health. There is very little public transport in Mow Cop, Rode Heath etc. The transport issue affects ALL patients, not just those in the Rode Heath area. If a patient can’t get transport from Rode Heath to Scholar Green, then the reverse is true, a Scholar Green patient can’t get public transport to Rode Heath.

Frequently asked questions • A promise was made to residents in Rode Heath Surgery that it wouldn’t close, what happened? • When Greenmoss Medical Centre was opened, the Primary Care Trust wanted the practice to close Rode Heath Surgery. The GPs chose to keep it open and said they would do so for as long as it was feasible. Unfortunately that time has now come. The building is no longer suitable for NHS services and the cost to correct this is a practice cost. There isn’t the space physically to ensure disability access requirements are met – this is for staff too, not just patients. The CQC inspection in January 2017 rated the premises at Rode Heath as ‘requires improvement’. NHS income has fallen greatly over the last few years and it no longer makes economic sense to keep both surgeries open when so much is required at Rode Heath Surgery to bring it up to standard • You must have known at the time the promise was made that you couldn’t keep it open? • The Rode Heath Surgery has remained open for 4 years after Greenmoss Medical Centre against the PCT wish for it to close. Unfortunately circumstances change and Rode Heath Surgery is no longer suitable as an NHS surgery Frequently asked questions

Frequently asked questions

• The size of the building is bigger than is needed – what proportion of the Greenmoss building is used? • The building was built for the future and expansion space was included as part of NHS planning. At the moment the building is currently occupied at approximately 85% making it adequate in size to accommodate Rode Heath Surgery appointments.

• Why was the meeting at Greenmoss and not at Rode Heath Surgery? • There was enough space at Greenmoss Medical Centre to hold the meeting. It is also centrally placed in the practice area and as all patients were invited to the meeting, this was deemed the most central location. There was not enough space at Rode Heath Surgery to hold the meeting

What happens next?

The practice application to close Rode Heath Surgery will be submitted to the Clinical Commissioning Group - Primary Care (General Practice) Commissioning Committee on the 28th July 2017 in Bevan House, Barony Court, Nantwich CW5 5RD.

This is a meeting held in public (not a public meeting) where members of the public can observe the meeting.

The practice application will also be heard at Cheshire East Council, Health, Adult Social Care and Communities Overview and Scrutiny Committee on the 6th July.

Therefore a decision will not be made until 28th July where the Primary Care (General Practice) Commissioning Committee will consider the application fully with the Health, Adult Social Care and Communities Overview and Scrutiny Committee comments.

The practice will then announce the decision.