Health bosses consider 'volunteer car service' after Hambleton's only GP practice closes - leaving patients with 'three hour bus trip' to see a doctor
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Chiefs at the Over Wyre Medical Centre permanently shut their base in the village last month after closing on a temporary basis in March.
Dr Luke Holmes, one of the practice's partners, said the building in Kiln Lane was "no longer fit for purpose" because "the standards required of NHS property have increased dramatically in recent years".
Clinical rooms are carpeted, they do not have appropriate sinks, and the lighting was judged to be poor, an NHS report seen by The Gazette said.
Social distancing was also found to be impossible there.
But it also came after a dispute with the building's landlords.
The practice's bosses claimed they wanted to buy the rented branch and bring it up to scratch, but said they were unsuccessful in their efforts - and later ordered to "terminate our occupation of the building with immediate effect and to vacate the premises of our possessions by August 7" because they did not sign a new lease until March 2022.
"Sadly, this ultimately means we have been left without a branch surgery to work from," partners Dr Claire Bolton, Dr Holmes, Dr Oliver Totty, Dr Vicky Simpson, and Dr Sarah Hopkins told patients in a joint statement.
"We have explored other options ... but have been unable to find any solutions.
"The enthusiasm within the community to fight this decision is commendable and we completely understand the sense of loss and alienation the community of Hambleton will currently be feeling."
Patients now face a four-and-a-half mile journey to the Over Wyre Medical Centre's main purpose-built base in Preesall, though they have been told they can try and register with a practice in Poulton, which has more frequent bus services, instead.
The 2C bus runs from Hambleton to Preesall around two times an hour during peak times.
And it was fears over public transport links, especially amongst the frail and elderly, which were voiced by 1,060 patients surveyed by local health service commissioners.
A report revealed: "These comments were primarily from patients of the Hambleton area who live close to the branch and are concerned due to their age and/or health conditions.
"A number have cited additional costs for taxis or bus fares, plus the journey time using a bus to and from Preesall from Hambleton could total two to three hours for an appointment."
The practice, which pays its GPs an average of £62,188 a year according to its website, is now considering a "volunteer car service" to taxi "patients that struggle", while "remote digital consultation" have also been introduced during the pandemic.
Dr Holmes added: "Our lease was also coming to an end and there was no real way to make the Kiln Lane building suitable within any realistic budget, so sadly there was no real choice.
“We are keen to make sure the closure does not impact patients too heavily and so will look to offer even more services at our Preesall site while working with our patients to help people who may struggle to get to our main site.”
The Hambleton practice "did not meet control of infection regulations", papers added, and "the services that could be provided there were very limited compared to the Preesall site that has a huge array of different services, including on-site medication dispensing for patients".
No other "suitable accommodation" for a practice in Hambleton could be found.
The pharmacy attached to the now closed surgery will stay open, despite rumours to the contrary, while the number of appointments on offer in Preesall will increase to meet the extra demand.
Resident Andrea Lomax wrote to local MP Ben Wallace to say the practice was a "godsend" during her battle with mental illness.
She said in her note, which she shared to social media: "Looking back, I feel if my doctor has been a 15-minute journey on public transport I don't think I would be here.
"The surgery saved my life in effect.
"It wasn't money that helped me, Mr Wallace, it was down to the fact that I was able to see a doctor in the village where I chose to live."
In a response, which was also shared online, Mr Wallace, who is also the UK's Defence Secretary, purportedly said the practice's partners told him "they are confident the closure will not have a major impact on patients".
He said: "They state that the vast majority of appointments take place at the Preesall site in Wilkinson Way, accessed via public transport from Hambleton.
"They advise that patients come from a vast area which goes as far as Cockerham to the north and Great Eccleston to the south.
"The GP partners advise that in closing the branch in Hambleton it will allow for the potential expansion of the site at Preesall, bringing even more services to the area, preventing the need
for people living in Over Wyre to travel to other parts of the Fylde Coast for some appointments."
Catherine Nicholson said: "Preesall is a long way away when you don't have transport and are feeling unwell."
And Gill Oakley said: "It took years to get that surgery in Hambleton and we had to go to Preesall. We also had to use their pharmacy.
"It's a nightmare journey by public transport if you are poorly."
Yvonne Walton, clerk at the parish council, which is working with the practice's patient participation group and residents, said the long-term aim is to find a buyer for the building so the practice can move back in following a revamp and reopen.
She said: "We are really starting from scratch. There are people who have said they are interested but it's early days.
"In the interim we are looking to support patients to get to Preesall to get the treatment they need."
The council will also lobby the practice to offer some services - such as annual flu jabs - from a venue in the village.
Ms Walton said she will push for more more detail over the volunteer car service, citing concerns over insurance coverage and criminal background checks for those offering to help.
Even if those obstacles can be overcome, the main road linking Hambleton to Preesall is the A588, which is one of Britain's most dangerous and has a long history of deadly crashes.
"If there's an accident, people will get stuck," Ms Walton said.
"If you are feeling unwell, or you are elderly or disabled, or fall into any of the vulnerable categories, to get to a bus stop would quite difficult," she added.
"There's no bus stop really close to the surgery in Preesall either.
"It's really quite a big deal, especially if people have to go on a regular basis."
Coun Julie Robinson, who represents the village for Wyre Council and chairs the parish council too, said the practice was not open full-time, with figures showing an average of just 121 appointments a week carried out there, compared to 1,634 in Preesall.
But she said: "We are trying to work with the residents," and voiced hope some medical services could return to the village.
And Kevin Toole from the Fylde and Wyre Clinical Commissioning Group's primary care commissioning committee said: "The people of Hambleton have shown they feel very strongly about this decision and so we will be working closely with the practice to make sure services are still available to people living in the area and are as convenient as possible."
Last year, a row between doctors at the Over Wyre Medical Centre led to an urgent meeting of health chiefs.
The legal dispute, between four GPs and fifth, led to the four threatening to dissolve their partnership, according to NHS documents.
That could have led to their contract with the NHS coming to an end - sparking fears over the impact of the 11,259 patients registered there.
But a crisis was averted after commissioners decided that, if the partnership was ended, a new contract would be given the four GPs so patients would not be impacted.
It meant it was business as usual at the practice, which is based in Wilkinson Way and had six partner GPs, though only four were practicing.
One absent GP, referred to in NHS papers only as Dr A’, told his colleagues in February 2018 “he was no longer able to practice due to a considerable increase in his indemnity fee resulting from a number of complaints”.
The other GP not working was Jerome Kerrane, who was struck off last year for abusing his position to enrol ineligible patients in clinical trials prior to joining Over Wyre Medical Centre.
He was not involved in the dispute.
The four remaining GPs had been “undertaking additional clinical sessions” and brought in an agency GP, while the NHS gave “resilience funding” to train “key practice staff to increase their clinical skills, ” the documents said.
Dr Holmes, speaking on behalf of the four GPs, said at the time: “Our priority is and will always be our patients.”
Have you been - or will you be - significantly affected by the closure? Contact our reporter by emailing [email protected]