GP super-surgery and '˜satellite healthports' the future of primary health care in Preston
A vision of the future for healthcare has been proposed in Preston - a GP super-surgery and a series of '˜satellite healthports'.
Plans are on the table for the new surgery in Fulwood, which is set to amalgamate five local GP clinics and offer some extra services and clinics which are currently based at Royal Preston Hospital.
But during the consultation period, issues have been raised by patients including the difficulty in travelling to the new super surgery, which is to be based at the former Little Sisters of the Poor care home on Garstang Road, and the potential increase in patients going to the A&E at Royal Preston Hospital, instead of a GP clinic.
Now members of Preston City Council are proposing to explore the possibility of ‘drop in’ facilities or ‘satellite healthports’ in the Plungington and North West Preston areas.
Plans for the super GP surgery in Preston are currently with city centre town planners and are likely to come to a planning development meeting in Spring.
If the proposals are successful the site will be the new home of the Lytham Road Surgery in Lytham Road, Medicom Surgery in Flintoff Way, and ‘The Surgery’ – made up of Beach Drive Surgery in Beech Drive, Drs Robb and Robb, and Moor Park, both in Garstang Road.
Those backing the proposals say the new space will cope with greater patient numbers, have more staff and appointments and offer a larger range of services to alleviate pressure on nearby A&E departments.
During the investigation councillors at PCC found that GPs at the five local clinics had spearheaded the case to merge the surgeries.
In his comments on the report scrutiny committee chairman coun David Borrow stated: “It became clear as we took evidence that it is the GPs themselves who drive the configuration of GP services in Preston.
“The NHS through the Greater Preston CCG and the Delegated Clinical Commissioning Group have a role but this is largely to respond to proposals from GPs.
“They do not see it as their role to determine where GP surgeries are best located in the interests of local residents.
“We believe the government should address this democratic deficit.
“If the proposals in respect of the super surgery are agreed and no surgery is established in North West Preston, we believe there is a need for accessible local health provision in both Plungington and North West Preston.”
In a meeting between councillors and Donna Roberts, head of Primary and Elective Care, Chorley and South Ribble and Greater Preston CCGs, one council member also enquired to the possibility of satellite healthports to be put in place if the five surgeries combine.
According to the scrutiny committee report Ms Roberts ‘indicated that it may be possible to look at this and discuss with the Lancashire Care Foundation Trust which delivers community services, if the need is identified in certain areas’.
Ms Roberts also told councillors that the CCGs put no pressure on GPs to merge.
Instead ‘entrepreneurial’ GPs were ‘instigating change to address modern challenges’.
Such challenges included serving a higher population and people living longer leading to an increase in long term conditions.
As part of the investigation councillors also questioned the lack of limits on consolidation of GP practices, particularly into single powerful companies and asked how it fitted into a public service model.
Speaking to the Post, Coun Borrow said he had concerns over where the power to make decisions about creating large GP surgeries came from.
He said: “You would have expected that there was somebody to decide what was in the public interest but it doesn’t seem to work like that.
“How does that decision get made? We have learnt more about where the power lies. It’s clear to us that it’s driven by GPs not by the NHS.
“I assumed the NHS made a strategic decision as to where GP practices are but that isn’t the case.
“I think there needs to be some democratic accountability as to where and how GP surgeries are delivered.
“When GPs were small I don’t think it made a lot of difference. Now we’re getting large conglomerates and I think the NHS needs to look seriously at that.
“It goes to the heart of the NHS where GP surgeries are independent business and not part of the NHS in the same way that hospitals are.”
Following up on this now forms part of the committee’s recommendations which are being taken to Cabinet at the Town Hall on Wednesday, January 23.
It also wants to explore what PCC can do as a planning authority through the North West Masterplan and planning policy to include adequate health provision in Preston.
Woodplumpton Parish Council has outlined its fears that traffic will be ‘encouraged’ to use the A6 to access the new super surgery on Garstang Road.
The parish body share concerns that the super surgery may have an impact on acute services with people go to A&E at the nearby Royal Preston Hospital in place of a clinic.
The report states: “In line with many other hospitals, Royal Preston is at breaking point in terms of admissions and delays at A&E.”
Will surgery be accessible?
Central Lancashire Integrated Care Partnership has responded to concerns that the new GP super surgery would mean some communities would be left without nearby access to a clinic.
The response stated: “Due to a number of changing demands on general practice the model of a large number of small practices is becoming unsustainable.
“In order to increase their resilience and sustainability they are looking at new models of care which allows them to respond to these demands.
“Practices are coming together to work at scale in order to make efficiencies in back office functions for reinvestment in clinical
workforce, to maximise their use of the wide variety of clinical roles available to them, to improve the range of services available to patients and to improve patient outcomes.
“For some patients this may mean that the new surgery is slightly further for them to travel, but all patients have the opportunity to raise their concerns with the practices as part of the engagement done prior to any move.
“One of the benefits of practices working at scale is the larger and more diverse clinical workforce available to patients in order to address their individual needs and improve waiting times for services. For most patients it is still more convenient to access their GP surgery than attend A&E.”