cockermouth logo
Patients' groups given update on
Cockermouth GP Merger

Around 50 members of the Patient Participation groups for both Castlegate and Derwent surgeries attended a meeting on Monday, June 1 2015 where GPs and the hospital manager explained the current situation. The meeting was told that the sudden departure of two GPs had led to a decision to merge the two GP practices.

It was stated the merger would lead to 'tangible benefits' and increased sustainability and the plan was to merge by October 2015. Dr Desert said the main aim was sustainability, both financially but also in terms of creating a unit that would attract GPs and continue a role in training. He pointed out that "10% of UK GP surgeries are having difficulty recruiting and some have sold out to Virgin Health Care." Dr Kingan said the merger had been necessary after two Derwent GPs left. The meeting heard that there had been seven possible applicants being considered.

There was praise and spontaneous applause from the meeting at the levels of service provided by the GP team. Dr Desert said the GP part of the new hospital had proved "much more expensive than expected". There was some disbelief when he claimed the running costs had not been disclosed until a year into the project. The meeting was told by Sid Williamson, Castlegate Practice Manager, that the first floor part of the hospital cost £230,000 a year in fees, with £170,000 for the surgeries. He said and organisation called CHP were the landlords and "we haven't paid a penny yet" as there were legal bids to get the contract adjusted.

Dr Desert added "we are stuck in a perfect storm." He said the problems faced by the acute hospital trusts meant those hospitals had not been able to progress moving services to Cockermouth. Yet again the meeting was given a promise of earlier and later opening times. Dr Desert was asked why there was no charge for car parking and he explained that the number plate recognition system was ready to be used and when it became live, patients would not have to pay and other users would get one and a half hours free access.

Addressing the meeting were: Mr Sid Williamson, Castlgate Practice Manager; Dr Simon Desert, Dr Mark Kinghan, Dr Rebecca Qualtrough; Dr Gill Campbell.
D.S.

Subsequent article in Times&Star newspaper:

A TOP doctor has revealed the challenges faced by staff at Cockermouth’s flagship community hospital.
Sixteen months after the £11 million hospital opened:
l Staffing issues mean services like X-rays and an ultrasound scanner cannot be installed
l Basic running costs are £230,000 a year - far higher than anyone had anticipated
l Large areas of the hospital remain unused, including the dental practice
l A full minor injuries service has not been funded
l Doctors are holding back payment to landlords
l There are fears that GP vacancies will not be filled
l Its pharmacy is not profitable
Dr Desert, of Castlegate Surgery, said while they and Derwent Surgery were happy working in the new building on Isel Road, it was frustrating for medical staff because politics gets in the way of healthcare.
He added: It's inordinately frustrating. We had to fight for a long time to get the building but actually constructing the services is proving more difficult than the building.
Multiple reorganisation in the NHS has created these problems.
The challenges that we face with our two acute hospitals makes it very difficult for them to focus on anything other than the most critical thing.
Being able to sort out a peripheral hospitals at Cockermouth is not on their A-list.
We have been a hostage to fortune with the times.
Doctors are keen for the acute trust, which runs the West Cumberland Hospital in Whitehaven and Carlisle's Cumberland Infirmary, to provide more outpatient services.
Dr Desert said it would benefit patients and save the NHS money.
He said: The NHS spends money in mysterious ways.
An emergency ambulance taking someone to the West Cumberland Hospital costs more than £350 for one trip. So many journeys would not be necessary if you could perform investigations closer to home.
By having more services based in the Cockermouth hospital it would also save the acute trust spending huge amounts on transporting patients to clinics at Workington, Whitehaven and Carlisle.
When plans for the new hospital were announced, patients were told that alongside the surgeries and hospital beds there would be a dental practice, X-ray and ultrasound and minor injury units.
But 16 months later, the many rooms built to house the additional services are in pristine condition and vacant. Large areas of the hospital sit unused.
The dental suite which was created but never filled is likely to be refitted so it can be used by another health care provider.
Dr Desert added: The acute trust have been to see it a number of times and are considering it.”
The hospital’s league of friends has money set aside for the ultrasound scanner but, according to Dr Desert: The acute trust is unable to commit to providing staff to use it.
The reality is they struggle to get staff.
Staffing is also preventing the opening of the X-ray service.
Dr Desert added: We have not got all the money for the X-ray service but are convinced we could soon raise that once we had a clear undertaking that we would have it staffed and functioning.”
The minor injuries unit is not funded yet so is restricted to practice hours.
He said: The minor injuries unit is complicated to staff because you need nursing staff specifically trained, they also need medical back-up.
But we feel run in conjunction with other services in the building we could provide a much more comprehensive service than we do now.
If we had the X-ray and scanner that would make it supportable.
The population is of a size where it is difficult to support individual services on their own, so everything is co-dependent on another service.
Everyone wants to be doing everything we promised.
The main thing within the NHS is the hospitals trust being in special measures, the funding gaps and constant political reorganisation.
You can be half on track doing something and then it changes again.
All the political parties would say what we have been trying to create here, integrated care, is the future but it's the future that we can't quite attain. Implementing it is the problem.
We designed this building at a time when we were an integrated care organisation where everything in Cockermouth was run as within one organisation.
The difficulties we have now is that every step you want to make, such as getting the X-ray service working, requires you to work with lots of different organisations.
It's very frustrating because politics gets in the way of health care, we need to get back to a sensible patient-centred programme rather than fragmentation.
The doctors are also concerned about the numbers of people using the pharmacy.
The purpose of it, apart from the ability to provide the pharmacy service over extended hours, was to make a small profit to subsidise the cost of the rest of the building.
But it's not profitable, its underused. I don't think patients are aware it helps finance the building.'
The landlords are the Department of Health-owned Community Health Partnerships.
It charges rent, which is paid by the NHS, and running costs, which are paid by the groups using the building.
In the minutes of a Patient Participation Group meeting held at the hospital recently, Castlegate practice manager Sid Williamson said of the running costs: The first floor of the hospital costs £230,000 a year, with £170,000 for the surgeries. This is double or even triple what other GPs nationally pay.'
Dr Desert explained: We were not able to get any assessment of running costs when we had to commit to having the building because we undertook to lease the building some two-and-a-half years before it was started.
The running costs are inordinately high and that places a very severe financial burden on the practices.'
The surgeries are contesting some of the bills and will not pay them until a satisfactory resolution is reached, Dr Desert said.
They did not receive a bill until a year after they moved in.
He said: We have paid the rent, since January 2014, but have contested and not paid the facilities management bills.'
He said the bills included heating, lighting, power, cleaning and some staffing.
Within that there are some services which we regard as wasteful and others we regard as inefficiently provided so we are contesting the way these services are being provided.
But however much we can negotiate these costs down we are left with a very substantial ongoing commitment,' said Dr Desert.
Although we live in one of the safest towns in England, the company that runs this building felt we needed seven-day-a-week 24-hour security guards.”
This has been cut back to after working hours.
They were also being charged for a porter service, which involved someone being paid to collect and distribute mail.
Dr Desert said: We only have two offices so this was not necessary. We asked them not to deliver letters but have not been advised of any reduction in costs.
They have a build manager who works seemingly full time. Ostensibly her role is to manage the booking of rooms but they do not have any rooms to book, therefore her only role is to co-ordinate repairs and manage the cleaners.
The cost on the budget sheet for that management role is, I think, £70,000.
We have been to director level with the company we rent the building from, the Community Health Partnership,s and we have taken this to board level. There will be another meeting next week. We may go to some form of arbitration.'
The GP practices are planning to merge following the resignation of two doctors from the Derwent Surgery.
They feel there will be many advantages to this, including helping with recruitment.
By merging they would have 17,200 patients, creating one of the largest practices in Cumbria. They are hoping to take on three new GPs.
Dr Desert said: Doctors and patients quite like to be in smaller practices but as more and more work is passed from hospitals to primary care it becomes very difficult to provide that breadth of services required in small practices.
The most sustainable solution is to merge the practices and work with teams within the practice. Hopefully we can then give patients as much of what they want and also make the practice look more attractive to prospective staff.
Recruitment of medical and allied health staff is extremely challenging in Cumbria at the moment, we have vacancies throughout.
Castlegate has always been able to recruit as it's a training practice but Derwent Surgery, following two resignations, would be looking at trying to attract GPs at a time of a national shortage.
We have had some applications but I am not confident we can fill all three roles.''
Tracy Walker
Cockermouth reporter
Times and Star


Details of merger plans on Castlegate Surgery website