'You're not welcome': Chorley GPs and staff threaten to boycot company poised to take over Withnell Health Centre as NHS bosses apologise to patients

It emerged last week that SSP Health had won the contract to operate Withnell Health Centre after a legally-binding bidding process in which the current GP, Dr. Ann Robinson, was unsuccessful.

The news drew a furious response from patients, with 1,500 objections being sent to the Lancashire and South Cumbria Integrated Care Board (ICB) - which assessed the bids - claiming that NHS leaders had written the wrong prescription for the future of the village service.

Staff at the Railway Road facility have also now indicated that they will quit if and when the new arrangement comes into force.

Dr. Robinson said that neither patients nor her workforce had been consulted and were unaware that there was a possibility of the practice being handed over to a conglomerate like SSP, which operates just under 40 GP surgeries across the North West.

The ICB has now issued an apology to patients, acknowledging that “more could have been done” to keep them informed about the process – and stressing that it is taking all of the concerns raised “seriously”.

SSP Health last week insisted that its aim for the practice was to “retain the team, continue their good work and add to the services available to patients”.

However, the Lancashire Post has learned that the Manchester-based operation faces being excluded from a local coalition of GPs in Chorley, of which Withnell Health Centre is currently a part.

“Chorley Together” is one of more than 1,250 primary care networks (PCNs) established nationwide in recent years. The collaborative arrangements are designed to enable practices to offer a wider range of services and more easily manage their affairs and recruit and retain staff.

Alongside the Withnell facility, the group is made up of representatives of Whittle Surgery, The Surgery Chorley - and its sister practices, Station Surgery and Leyland Surgery - and Dr. Marcus Jacobs and Dr. Raffi Baghdjian's surgery on Collison Avenue.

Chorley Together PCN’s business manager has now written to the ICB board to express its members’ “dismay and concern” at what they describe as the “fundamentally flawed” procurement process that last week led to SSP Health being advised that the ICB intended to transfer the Withnell Health Centre contract to the firm.

Claire Hounslea also warned in the letter that the network would not be welcoming the regional company to the local fold of GPs.

“The values and behaviours of SSP do not align with [those] of Chorley Together PCN and its member practices. The impact of the ICB’s decision cannot be underestimated.

“The board of Chorley Together…will not accept SSP into the PCN if they remain the ICB’s preferred bidder for Withnell Health Centre from 1st April, 2023. We will not be intimidated or bow to pressure from the ICB to do so,” the correspondence concluded.

Dr. Robinson currently acts as Chorley Together's clinical director and the network claims that the stability of the fledgling group - established last May - could be put at risk by the “inevitable funding cuts” that would come from a move to exclude Withnell Health Centre from its number.

PCNs also often collaborate over care home services and are designed to better integrate the different parts of the health and social care system.

Meanwhile, a receptionist at the Withnell practice says she and other long-serving colleagues would rather resign than see the surgery handed over to SSP Health.

“Many of the staff, including me, are from this community - we grew up together, we went to school together,” Jayne Breen said.

“How can I possibly stand next to a friend in the bakers, knowing that we are going to be delivering care to them and their families in a way that I fundamentally disapprove of?

“I do not want to tell patients that they will have to discuss their health concerns with a call-centre operator, or that we no longer do home visits, or that they cannot see one of our doctors when it is convenient to them.”

Dr. Robinson said that “it is hard to see how the practice can continue” in the event of a staff exodus in the wake of her own unplanned departure this spring.

“[The ICB] are breaking a model of best practice and replacing it with a system that compromises care in favour of profit,” she added.

Commenting on the seeming pincer movement against his firm by the area’s GPs and current Withnell Health Centre staff, Andy Scaife, chief executive officer of SSP Health, said that the company was “surprised and disappointed” to have learned of the primary care network’s intentions, “especially while the process is still ongoing and no details of the transition have been given to the PCN”.

“To date, neither Dr Robinson, …[nor] any member of the board of the PCN has reached out to us to make any attempt to understand our model, values and behaviours, as well as our intentions for this well-loved practice. And as such, statements relating to our values and behaviours are unfounded and not based on any facts.

“We have already contacted Dr Robinson and would of course very much welcome the opportunity to engage with her, as well as the members of the PCN, to enable us to discuss and allay any concerns, worries and misconceptions that they may have.

“At this moment, the ICB have confirmed that they intend to award the contract to SSP Health. As such, we very much look forward to working with all of the staff at Withnell Health Centre, including Dr Robinson if that is what she would like.

“We work successfully, collaboratively and actively with 16 PCNs and we are often at the forefront of driving improved care and service to patients in those areas. We would welcome the opportunity to bring our learning and skills to bear here and help the Chorley Together PCN move forward in their future endeavours.

“Our understanding is that Withnell Health Centre is an active member of the Chorley Together PCN and we expect that to remain that way in order to ensure the best possible patient care,” Mr. Scaife said.

He added that home visits were available to patients at all SSP-run surgeries and said that the company’s “single mission is to deliver high quality care”.

“We intend for this to be no different at Withnell Health Centre. The high quality care that we deliver is clearly demonstrated by our excellent CQC ratings, with all of our practices rated as either good or outstanding and is further supported by our Google review ratings, which average 4.1 stars and are rising.

“We are heavily integrated into the local communities that we serve and work very closely with our teams to take into account the need[s] of every single patient to ensure they get the care they need in the way that suits them.

“Indeed, our model is to support the wider NHS and provide services for patients more conveniently and closer to home.”

Last week, the the former lead partner of the Withnell Health Centre, Dr. Margaret France – who worked at the facility for a total 30 years

before retiring in 2013 – contrasted the performance of many of SSP Health’s practices with that of Withnell Health Centre in the latest GP patient survey. Dr. Robinson’s surgery was – often significantly - above the national average in all bar one measure, where it equaled that average.

HAS EVERYONE HAD THEIR SAY?

The Post understands that the clinical director for a primary care network (PCN) in the Lake District - which is also part of the Lancashire and South Cumbria Integrated Care Board patch - was involved in the procurement process for a practice in that area which went through the re-tendering procedure last year.

While that exact arrangement could not have been replicated in the case of Withnell Health Centre - because of Dr. Robinson’s occupation of the clinical director role in the Chorley Together grouping and the fact that she was one of the bidders - the contrast appears to reflect the differing levels of PCN engagement in procurement activity across the wider region.

That is likely to stem from the fact that the ICB inherited the legacy arrangements of the eight now defunct clinical commissioning groups (CCGs) it replaced last July.

Those organisations had hitherto been responsible for securing GP services in their own areas. Chorley and South Ribble CCG began the tendering of the Withnell Health Centre contract early last year.

At the time, it wrote to patients to advise them that Dr. Robinson had been given a temporary contract to run the facility, following the dissolution of the previous partnership that had operated the practice - in which she was the senior partner - which had sparked the then legally-required re-procurement.

The CCG also invited patient views on their experience of using Withnell Health Centre, which it said would feed into the analysis conducted ahead of the awarding of a new contract. The Post understands that the legal threshold for public consultation has been met.

The ICB was later obliged to carry out the process of procuring a new long-term operator for the practice, based on a series of questions about how potential providers planned to deliver the service. Eligible bidders were then scored and the submission which achieved the highest marks was awarded the contract.

Maggie Oldham, deputy CEO of the Lancashire and South Cumbria ICB, said that a representative had met with staff to “discuss their concerns”.

She added: ““Due to the contract at Withnell Health Centre being an interim arrangement, the NHS in Lancashire and South Cumbria had a duty to undertake an open, procurement process for this service which allows for all interested providers to be fairly considered. This is part of our legal responsibility as an ICB in accordance with NHS and public procurement regulations.

“The ICB was obliged to run a full procurement process for a new contract after Dr. [Mahtab] Siddiqui informed the CCG that he had dissolved this partnership, resulting in the termination of the existing contract with immediate effect. In the meantime, to ensure continuity of services for patients, on 9th December 2021, Chorley and South Ribble CCG’s Primary Care Commissioning Committee made the decision to award a temporary contract to Dr Ann Robinson.

“The ICB has received a large number of letters, concerns and comments from staff, patients and residents and we would like to assure the public that these are being actively processed. We are taking all concerns raised seriously.

“As with all procurement exercises, engagement with the public was part of the process. In regard to Withnell Health Centre, all patients were sent a letter informing them that a temporary contract had been awarded and that there would be a process undertaken to identify a long-term provider. They were also invited to submit their views via a patient survey and there was an approximate 11 percent response rate; however, we’d like to acknowledge that more could have been done to keep patients informed.

“Further engagement could have made patients and staff more aware of the procurement process and that it could result in a different organisation taking over the running of the GP practice and due to this we would like to apologise.

“We are currently reviewing all the information from the procurement process and at this point have not entered into a contract with a new provider.

“Going forward, we’re committed to going above and beyond with our public engagement and would like to reassure our local population that securing high-quality services remains a priority for the ICB,” Ms. Oldham added.