The future of Trinity Medical Centre – summary of feedback from engagement with patients

Background

The Care Quality Commission (CQC), which is the regulator of health and social care in England, cancelled the registration of the previous service provider at Trinity Medical Centre, which meant that it was no longer authorised to provide services there. The full inspection report can be found on the CQC website.

Since 16 September 2022, another local surgery, Tudor Lodge Health Centre, has been managing the practice on a caretaking basis, so that patients could continue to access GP services at Trinity Medical Centre, while decisions were being made about the future of the practice. The caretaking contract is coming to an end on 31 July 2023, as mutually agreed between Tudor Lodge Health Centre and NHS South West London.

With Tudor Lodge’s caretaking contract ending on 31 July 2023, an urgent decision was required on the future of the practice.

The proposal

NHS South West London proposed closing the practice and asking patients to register with another local practice of their choice, with additional measures in place to support the most vulnerable.

We engaged with patients and local stakeholders to get their feedback. The NHS South West London Governance Committee considered this feedback when making its decision.

Engagement opportunities

To get people’s views we held a drop-in session at the practice on 27 April 2023, attended by more than 200 people. There was also an opportunity to submit feedback by email or over the phone, by the deadline of 15 May 2023. We received 100 emails and around 80 calls.

What people told us

Disagreement with the proposal to close the practice

• Some patients said that they were aware of issues at the practice but felt that the quality of services had improved since the caretaking provider took over and they would like the caretaking provider to continue.
• Other patients were still dissatisfied with the quality of services, notably difficulties booking appointments online and over the phone, and suggested that a new provider should be brought in to run the practice.
• Some suggestions to keep the practice open included financial support from NHS South West London or the recruitment of new staff.
• Some people raised concerns about local GP capacity.

In response:

NHS South West London has explored keeping the practice open by finding a new provider. Unfortunately, this is not a viable option and could cause further disruption to patients, affecting care in the long term. The number of patients registered with the practice is small (less than 6,000). In our experience, a new provider would find it challenging to be viable with the funding available.

We are grateful to Tudor Lodge for urgently stepping in to allow for plans to be made for the future – like us, Tudor Lodge don’t think extending this current arrangement is a viable long-term solution.

Agreement with the proposal to close the practice

Some patients explained that they have had unsatisfactory experiences with the practice in recent years and they understood and agreed with the proposal to close the practice.

The impact on other local practices

• There were concerns that there may not be sufficient capacity among local practices to take on all patients from Trinity Medical Centre.
• Some patients said that they had been turned away from practices when trying to register, although in some instances this was due to the patients not falling within the practice boundary.
• Patients requested a list of practices they would be able to register with.

In response:

A review of local practices has showed that there is sufficient capacity to take on the patients from Trinity Medical Centre. Patients can register with any of these practices, as long as they live within its boundaries. We are sending patients a list of local GP surgeries and their contact details, as well as details of how to find an alternative GP via the NHS website. Practices receive funding based on the number of patients who register, and would be able to recruit additional staff if required.

Travelling to a different GP surgery

Some patients felt that travelling to a different practice may be more difficult for them, compared to Trinity Medical Centre, with its good transport links.

In response:

There are 31 practices within two miles of Trinity Medical Centre, which all benefit from the good transport links in the area. Most of these practices are within 0.1 miles of the nearest bus stop, tube or train station, and all are within 0.3 miles. Support is available to vulnerable patients to help them plan their journey to a new GP surgery.

The impact on vulnerable patients

People raised concerns that the most vulnerable patients might find the closure of the practice distressing and asked what support would be available with finding another practice.

In response:

The practice will identify its vulnerable and housebound patients and contact them to provide direct support to help them to register elsewhere and with other issues. Translation, dial-a-ride and home visiting services will continue to be available.

Medical records and repeat prescriptions

Some patients asked what would happen to their medical records, test results, referrals and repeat prescriptions.

In response:

When patients move to a new practice, their medical records are transferred electronically, including test results and repeat prescriptions. The new practice may arrange a medication review, which could lead to a change in medications. Hospital and other medical appointments external to the practice will not be affected by a change in GP.

Decision following engagement

After carefully considering the feedback received during the engagement period, NHS South West London has taken the decision to close the practice on 31 July 2023.

We have explored every practical option to keep the surgery open but believe this is the only way to ensure people receive services that are safe and high quality.

We heard people’s concerns, and comments that the quality of services had improved since the caretaking provider took over. But we believe these changes will improve the GP services people receive for the long-term.

We have confirmed with the surrounding practices that they have capacity to take on extra patients and will continue to work with them going forward. Practices would recruit additional staff if required based on the number of people registered.

All patients registered at the practice will receive a letter asking them to register with a new local GP surgery of their choice, before the closing date. The letter includes the details of the closest surgeries, which can also be found on the NHS website.

People can find out how to register at these surgeries by visiting their websites – or calling the reception team, if they do not have access to the internet.

Patients have been urged, if they take regular medication, to make sure they ask Trinity Medical Centre for an adequate supply before registering with a new surgery, to avoid any disruption to their access to medication during the registration period.

Key reasons for the decision

• The Care Quality Commission (CQC), which is the regulator of health and social care in England, cancelled the registration of the previous service provider at Trinity Medical Centre, which meant that it was no longer authorised to provide services there.
• We are grateful to Tudor Lodge for urgently stepping in to allow for plans to be made for the future – like us, Tudor Lodge don’t think extending this current arrangement is a viable long-term solution.
• The number of patients registered with the practice is small (less than 6,000). In our experience, a new provider would find it challenging to be viable with the funding available.

Responding to concerns about the most vulnerable

• As part of the practice closure, staff at the surgery will lead on identifying vulnerable registered patients and reaching out to offer support.
• We will meet the practice weekly to check on progress – such as where people are registering and numbers yet to register – and review arrangements for the most vulnerable. The practices where people register will receive additional funding to ensure patients get the support they need as well as an increase in their overall funding, based on the number of patients they serve.
• As the contract comes to an end, anyone who remains registered with Trinity Medical Centre, will be registered directly with a new practice, for which they are within the catchment area. Their new practice will make contact to offer a health check.