Appendix 7: Patient Consultation and Engagement Report 1 November 2018 to 11 January 2019

Name of Practice(s): Ladybarn Group Practice and Burnage Healthcare Practice

Overview of the proposed change to GP practices involved

Please include the following information:  Practice list size for each GP practice  Neighbourhood information / demographics for each GP practice area – please highlight if the proposed changes will impact on patients registered with the practices but live outside of Manchester  Any communities of interest or identity and any adverse impact on them  Explanation of why proposed changes are being consulted on

The practice list for each GP practice is:  Burnage Healthcare Practice has approximately 2,300 patients  Ladybarn Group Practice has approximately 10,600 patients

Each GP practice sits within the following neighbourhoods:  Burnage Healthcare Practice - Didsbury (East & West), Burnage and Chorlton Park  Ladybarn Group Practice - Fallowfield, Old Moat and Withington

The distance between each practice is within 0.8 miles.

The neighbourhood profiles for Fallowfield, Old Moat and Withington can be read here https://secure.manchester.gov.uk/downloads/download/6527/neighbourhood_profile_-_fallowfield_old_moat_and_withington

The neighbourhood profiles for Didsbury (East & West), Burnage and Chorlton Park can be read here

Prepared by Val Bayliss-Brideaux, Senior Engagement Manager, NHS Manchester CCG – Amended October 2018

https://secure.manchester.gov.uk/downloads/download/6526/neighbourhood_profile_- _didsbury_east_and_west_burnage_and_chorlton_park

The neighbourhood has a higher proportion of adults (46%) and older people (16%) in the Good Health cohorts compared to Manchester overall (37% & 9.7%). Conversely, the proportions of people in the remaining adult and older people cohorts are slightly lower than Manchester. These cohorts are: Adults with Multiple Long Term Conditions / End of Life; Mental Health, Learning Disabilities or Dementia; Complex Lifestyles; Maternity; Frail Older People and Adults with Wider Determinants of Need.

Around 60% households in Burnage contain people whose social circumstances suggest that they may require high or very high levels of support to help them manage their own health and prevent them becoming high users of acute healthcare services in the future.

We know that 31 per cent of Burnage residents are registered with the Ladybarn Group Practice and 21 per cent are registered with the Kingsway Medical Practice. 11 per cent of Burnage residents access their primary care at Burnage Healthcare Practice.

There are currently patients registered at both GP practices of people who live in Stockport. At the Patient Participation Group meeting a brief discussion did take place regarding what difference it would make to patients living outside of Manchester. Any impact on care or receiving services would be discussed at an appropriate time with the individual patient.

Both GP practices are registered as “Good” by the Care Quality Commission.

The community of interest identified that the proposed changes may impact is older people and the lack of direct public transport and distance to Ladybarn Group Practice. Burnage is expected to experience the third largest increase of the over 65 population between 2018 and 2027 (509 additional people).

Dr Chadwick is planning to retire in May/June 2019. He approached Ladybarn Group Practice and asked us to consider taking over his contract and merging. The proposed changes are to formally merge the contracts, and deliver care and services from one site, namely Ladybarn Group Practice.

List the stakeholders to be involved and engaged as part of this consultation

 Patients at both GP practices  Neighbourhood GP practices – Barlow Medical Centre, Bodey Medical Centre, Borchardt Medical Centre, Didsbury Medical Centre, Kingsway Medical Practice and Mauldeth Medical Centre  Executive lead for health and wellbeing – Councillor Bev Craig  Chair of the Health Scrutiny Committee – Councillor John Farrell  Ward councillors in neighbourhood and surrounding neighbourhoods if needed – Councillor Ben Clay, Councillor Bev Craig and Councillor Azra Ali  Manchester Primary Care Partnership  South Manchester GP Federation  Manchester Local Medical Committee  Manchester Local Dental Committee  Manchester Local Optical Committee  Greater Manchester Local Pharmaceutical Committee  Healthwatch Manchester  Manchester University Hospital NHS Foundation Trust  Neighbourhood voluntary and community sector groups – BUZZ, Southway Housing and Burnage Good Neighbours  MP Jeff Smith  Boots Pharmacy, Burnage Lane  Tesco, Burnage  Burnage Community Centre  Burnage Library

What methods did the lead practice use to seek the views of patients on the proposed change at both practices involved?

Please include dates and ways information has been shared

 A letter has been sent to all Burnage registered patients during December 2018.  Leaflet displayed in Boots the Chemist, Burnage Lane in December 2018.  Leaflet displayed in Tesco, Burnage Lane in December 2018.  Information leaflet displayed in Burnage Health Care Practice in December 2018.  Information leaflet displayed at Ladybarn Group Practice in December 2018.  Message on the Jayex system at Ladybarn Group Practice during December 2018 and January 2019.  Dr Walkley Partner at Ladybarn Group Practice met with Cath Biggar from Burnage Good Neighbours in January 2019  Patients from both GP surgeries were invited to attend the Patient Participation Group meeting on 10 January 2019.  Face to face conversations have been taking place with patients at Burnage Practice for a longer period of time since the contract changes took place. This was because Dr Chadwick and reception staff at the practice were aware of his plans to retire in May/June 2019.

How did the practice ensure a range of materials and formats were used to engage as many patients as possible?

The practice provided the information in the following formats and materials to patients:

 Verbal via face to face conversations with patients  Information posters at both GP practices  Website information on both GP practice websites  Written information via letter to all patients registered at the Burnage Healthcare Practice  Verbal and written at the Patient Participation meeting held at Ladybarn Group Practice for all patients to attend  Information displayed on the Jayex screen at Ladybarn Group Practice  Paper feedback slips for patients available at both GP practices  Post box provided at Burnage Healthcare Practice for feedback in written format to be dropped off at anytime during GP practice opening hours.

What timescales were given to the patient and stakeholder consultation for both GP practices involved?

Please list from when patient and stakeholder consultation started and due to finish.

1 November 2018 to 11 January 2019.

Please provide examples of materials used i.e. letters, posters, website links

Here is the website link for both GP practice website where information was displayed:  https://www.ladybarngp.co.uk/  https://www.burnagehealthcarepractice.co.uk/

Here is a copy of the poster used to share information about the proposed merger of the GP practices.

Here is a copy of the letter posted to all Burnage Healthcare Practice patients:

We are writing to inform you of our proposed merger with Burnage Healthcare Practice.

You may already be aware that the GP’s at Ladybarn Group Practice have been working alongside Dr Chadwick since June 2018.

We are working to improve access to services at Burnage Health Care Centre.

We have started to implement changes, including all day Wednesday appointments (offering these appointments at Ladybarn Group Practice), access to additional services such as family planning and the option of seeing a female GP, which have proven very popular.

Ladybarn Group Practice are able to offer a broad range services to all of our patients including:-

 Access to specialised family planning clinics  Minor surgery for lumps and bumps  Ultrasound scanning  Counselling for adults over the age of 18 years  Direct access to Citizens Advice Manchester hotline and dedicated team  Chronic disease clinics managing our diabetic and respiratory patients  Monthly dementia clinic  Travel services.

We want to ensure that the patients currently registered at Burnage Healthcare Practice are also able to benefit from these services, and that our current high standards of care are sustainable.

The best way for us to be able to offer all patients increased access to a larger clinical team and to the services listed above, would be a complete merger of patient lists.

As part of the merger of the patient lists, we are proposing to operate from a single site. This would be from the Ladybarn Group Practice.

We wish to offer reassurance that housebound patients currently registered at Burnage Healthcare Practice will still be able to access GP services as usual.

As part of the proposal to merge onto one site we would very much welcome your feedback on this.

You can contact us by:  Sending an email to [email protected]  By leaving a comment on the Ladybarn Group practice website www.ladybarngp.co.uk  Complete a comment card at Burnage Healthcare Centre  Telephone Ladybarn Group Practice on 0161 448 4500  Attending our next Patient participation Group meeting on Thursday 10th January 2019 at 4pm held at Ladybarn Group Practice.

The closing date for feedback will be Friday 11 January 2019.

Yours sincerely, Dr Helen Burgess (Partner Ladybarn Group Practice)

Here is a copy of the patient feedback slip which was available at both GP practices:

How was patient and stakeholder feedback logged?

All feedback collected and stored in file. This was analysed and logged by theme – see below

Burnage feedback Ladybarn feedback Positive Compliments about GP Peter Chadwick and Positive Appreciation of the benefits the merger will bring and can reception staff see advantages Positive Appreciation of the benefits the merger will Positive The practice is accessible and there is a lift bring and no objections Positive Availability of a female GP/s to discuss issues Negative Lack of parking at Ladybarn if additional patients are to be going there for appointments Positive Choice of GPs available at both practices Negative Patient experience of practice staff being unfriendly and not approachable Recognised importance of having a GP practice/service in Burnage

Negative Lack of personal transport to get to Feedback points from the Patient Participation Group meeting appointments at Ladybarn / older patients  Patients felt reassured at the number of GPs that are currently No direct bus route from Burnage to Ladybarn available at the Ladybarn Group Practice and that GP available time at Burnage at increased Mobility issues for patients living with long term  Patients felt reassured that they would all have a named GP conditions or disabled / older patients when the practices formally merge  Patients felt reassured that those with individual complex needs Burnage GP practice too far to travel would have a named GP and that care pathways would not change Negative Patients do not want the Burnage practice to  Parents felt reassured that children/young people registered at close Burnage with long term complex needs would have a named GP and that care pathways would not change GP practice is close to where people live and  Patients felt reassured that a red flag system would be used to do not want to change practices or locations identify particular needs of individuals Negative Worry about continuity of care by patients living  Patients felt reassured that repeat prescriptions ordering would with long term conditions or parent carers of not change or where these where delivered from young people living with long term health  Patients living out of area (Stockport) who are registered at the conditions Burnage practice were reassured that they could continue to be Negative Lack of parking at Ladybarn if additional registered with Ladybarn Medical Practice. Any change in patients are to be going there for appointments delivery of services would involve a discussion with the Negative Loss of GP Peter Chadwick if he is planning to individual patient to ensure their needs were being met retire and patients are frightened of change  Individual patients were frightened of change but stated they felt reassured following the meeting and listening to the GP Negative Concerns about an increase in waiting times for  Patients understood that due to Dr Chadwick retiring they could appointments if practices merge not stayed registered with him or continue to see him following Negative Concerned at what will happen to the his retirement healthcare centre if the GP practice is to close  A written statement from Dr Chadwick updating patients on his plans to retire and his choice to work with Ladybarn Group Practice was shared at the meeting and gratefully received. This statement will be added to the Burnage GP practice website  Patients welcomed the opportunity to have a telephone triage call from a GP which could prevent the need for an appointment and travel to Ladybarn Group Practice

 Patients welcomed the additional services provided at Ladybarn Group Practice for female patients and the choice of a female GP  Patients did express concerns about the distance to Ladybarn from Burnage. Some patients agreed that this would no longer be an issue for them following the meeting.

What was the outcome of the patient and stakeholder consultation?  Include the number of responses received face to face, online,, through post etc  Include a sample of anonymised patient responses

We received 70 responses by email, feedback form, written letter and via the Ladybarn Group Practice website. Please see themed table above for responses from patients.

What issues were raised during the consultation from patients and stakeholders for each GP practice and how will these be addressed?

The themes from the feedback will be addressed or were addressed as follows:

 Transport – Dr Walkley is in discussion with Burnage Good Neighbours to look at transport issues and how these can be addressed.  We will promote ‘Ring and Ride’ to our patients at Burnage.  We will promote Transport for Sick Children to our parents of children/young people who are registered at both practices.  Pharmacy – still use as normal with a 48 hour request turnaround.  Named GP – patient can choose GP of their choice and change the named GP on the records.  Electronic Prescription Service (EPS) - This remains as with Burnage Healthcare Practice. Prescriptions can be sent to named Pharmacy as chosen by the patient.  Concerns around the closing of the Healthcare Centre – We have confirmed that this was not closing and Burnage Health Centre services will continue.  Patients wanting to continue with Dr Chadwick - Information has been shared that Dr Chadwick is planning to retire in May/June so this is not an option. A statement from Dr Chadwick was shared at the Patient Participation Group meeting and this has been added to both GP websites. A copy of the statement is below:

STATEMENT ON BEHALF OF DR. PETER CHADWICK Dr Chadwick has been a partner at Burnage Healthcare Practice for over 30 years. He has made the decision over the last year or so to gradually step down from his work as a General Practitioner and enjoy his eventual retirement. As part of his succession planning, and to ensure a high standard of ongoing care and continuity for his patients, he approached the partnership at Ladybarn Group Practice to assist him in this transition. The Ladybarn partnership has also been able to make sure through the process that the existing staff members at Burnage Healthcare Practice have ongoing job security. Dr Chadwick believes that Ladybarn have the best interest of his patients at heart, and trusts they will provide a good service, wherever they choose to provide it. He has every confidence in the Briarfield Road site.

Are there any changes to the practice proposal as a result of patient feedback?

We have taken on board the concerns with regards travel and transport to the Ladybarn site, that have been raised by a small number of patients. We are planning to review the difficulties patients experience and where necessary consider other options, eg ring and ride, organised transport facilities from the healthcare site to Ladybarn.

We have received patient feedback and have held a Patient Participation Group Meeting at Ladybarn Group Practice for both patients at Burnage Healthcare Practice and Ladybarn Group Practice. This was an incredibly useful exercise to provide facts to both patient groups and to able to advise that Dr Chadwick is retiring – and therefore the option of staying with him as their GP was no longer viable.

Both sets of patients were in agreement with the changes following the meeting – with several Burnage patients asking to register with Ladybarn of immediate effect.

Therefore there are no further changes to Ladybarn Group Practices proposal for merger following receipt of patients feedback. We continue the proposal to move both GP practices to one site at Ladybarn Group Practice 54 Briarfield Road Withington Manchester M20 4SS.

How will the practice report the outcomes and next steps to patients?

Following the committee meeting on 28th January 2019 information will be shared via posters and both GP websites on next steps.

Any formal action needed to be taken information will be shared via letters to Burnage patients.

Recommendation to the Primary Care Contracts and Improvement Group:

The recommendation is to formally merge the two GP practices and move the Burnage Healthcare Practice patients to one site and operate from the Ladybarn Group Practice.