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whp smallPatients attending meetings at Park Lodge Medical Centre in Old Park Road have been briefed about plans to transfer all its services to a surgery in Winchmore Hill, probably in late 2017. 

The GP partners from Winchmore Hill Practice, who are now also the partners at Park Lodge, have provided PGC with a document giving answers to questions which they have received from patients at meetings (see the box at the end of this article)

winchmore hill practice

Winchmore Hill Practice is housed in modern purpose-built premises at 808 Green Lanes (almost as far as the former Green Dragon pub and adjacent to the Esso/Tesco service station).  It currently has five GP partners, four salaried doctors, two GP registrars and a full nursing and adminstrative team.  There is parking for around 45 cars.

www.winchmorehillpractice.nhs.uk

Meetings

So far two meetings have been held at Park Lodge and a third is scheduled for Monday 3rd July at 6.30pm.  The planned changes and the reasons behind them were explained by former senior partner Dr George Koloumas and the senior partner at Winchmore Hill Practice, Dr Rizwan Noor.

The Park Lodge practice has in recent times been affected by the departure of former GP partners, including Dr Janet High, who retired (but still works as a locum), and Dr Stephen Parkinson, who moved to another practice, and, in common with surgeries throughout England, has had difficulty recruiting other permanent GPs.  Lately the only permanent GPs have been Dr Koloumas and Dr Deborah Gill, apart from whom there has been a trainee GP and several locums.

"Needing improvement"

However, the immediate cause of a crisis at Park Lodge was the fact that a Care Quality Commission (CFQ) inspection carried out in 2016 found the practice "needing improvement" in regard to some administrative aspects and, more importantly, in infection control measures.

Dr Koloumas said that resolving the infection control problems would necessitate costly changes to the building, including replacing flooring and wash basins.  He explained that the advent of CQC inspections meant that many of the hygiene and other stipulations associated with hospitals were now being applied to GP surgeries, and this was causing problems for many traditional GP surgeries - those using converted houses, such as Park Lodge.  In fact, NHS England is keen to do away with smaller surgeries and concentrate GPs in larger purpose-built premises offering a wider range of services.

New partners take over

Because of the infection control problem the CQC could have closed Park Lodge overnight unless it had a plan to resolve the problem. The transfer to Winchmore Hill Practice is that plan.  Not only do the Green Lanes premises meet all the CQC requirements, but Winchmore Hill has a stable medical team with hardly any need to employ locums.  The first phase of the changes occurred in April, when Dr Koloumas ceased being a partner - he now works as a locum (he intends to retire in July).  The new partners are the five Winchmore Hill Practice partners, who are now running both practices.

The plan to transfer patients between practicies needs to be approved by NHS England, and the hope is that this will be granted at the NHSE board meeting in July or, failing that, in September.  Once the go-ahead is given it will take two to three months to implement the move.

New doctors for Park Lodge

The GP partners will be taking on three new permanent GPs and a new practice nurse in August or September.  Initially they will work at Park Lodge, but when it closes they will transfer to Winchmore Hill Practice.  To make room for the additional doctors and nurse the dermatology and opthalmology clinics will move out - these are in fact provided for hospital patients, not for Winchmore Hill Practice's users.

Once the move goes ahead, patients will be automatically transferred to Winchmore Hill Practice - they won't need to do anything.  Despite the fact that many (between 40 and 50 per cent) of Park Lodge's patients live outside the Winchmore Hill Practice's catchment area, home visits will be available when needed.

Same-day appointments

Dr Noor is confident that Winchmore Hill will have sufficient capacity to deal with Park Lodge's 8,500 patients in addition to the 16,500 that it already has.  She explained that Winchmore Hill will always provide same-day appointments (they don't need to be "urgent", but patients can't specify a particular doctor).  However, waiting times for future appointments with specified doctors are around three weeks.

The main disadvantage of the plan, of course, is the location of the Green Lanes surgery, and for many patients living in Palmers Green it will be too far away to walk.  Dr Noor said that other surgeries in Palmers Green were aware of the impending closure of Park Lodge and should be able to take on patients who would prefer not to travel so far.

Proposed relocation of Park Lodge Medical Centre (PLMC) to Winchmore Hill Practice (WHP)

1.    Who are Winchmore Hill Practice?

WHP is a large training practice based at 808 Green Lanes. The practice is located in a purpose built building which is fully compliant with CQC (Care Quality Commission) requirements. It has good access for patients and meets the needs for disabled, elderly and all other patient groups. It has a stable workforce with 5 GP partners, 3 salaried doctors and currently 4 trainee doctors. The doctors offer full medical services and in addition offer joint injections and full contraceptive services including coils and implants. It has a full nursing team with a nurse practitioner and 2 practice nurses, trainee nurse and 2 health care assistants. The practice has a full administrative team with receptionists, secretaries and a practice manager.

2.    Why and how are Winchmore Hill Practice involved with Park Lodge?

WHP was approached by Dr Kouloumas and the CCG last year following a CQC visit which rated the practice as “requires improvement” and following the departure of Dr Parkinson. The CQC identified area within the administrative processes that needed improvement and also identified premises issues relating to infection control. WHP were asked to work collaboratively with PLMC to help resolve the issues and as Dr Kouloumas was planning to step down from his partnership role with a view to retirement the partners of WHP were asked to take over the practice. As of April 2017 Dr Kouloumas is no longer a partner at the practice but continues to work on a locum basis.

3.    Why does the practice need to relocate to the WHP site?

The original plan when WHP was asked to work with PLMC was to continue to offer medical services for the next 3 years with a view to formally request to relocate the practice to the WHP site so the building could be returned to Dr Kouloumas to reconvert back to residential purposes at that time. Unfortunately, as the building at Park Lodge does not meet CQC requirements we are proposing a plan to NHS England to allow us to relocate the practice this year.

4.    Will the practice close down?

The practice will NOT be closing down and will continue to see patients as there is a formal approval process that needs to happen. Once this has taken place and if NHS England agree to the plan all services will move across to the Winchmore site. This will take several months and at that time all PLMC patients will receive letters with details about the move.

5.    What happens to the staff and doctors at PLMC?

Currently there are no regular employed doctors working at PLMC apart from Dr Gill. There is a national shortage of GPs and unfortunately it is very difficult to recruit new partners and regular doctors. With the difficulties PLMC has faced over the last few years it has been even more difficult to recruit and WHP has been working extremely hard and we now have 3 new doctors and a new nurse practitioner starting in August/September. These doctors were employed on the basis that although they would start working at PLMC they would move to WHP following the relocation of PLMC. With the resulting increased patient numbers we would require more administrative staff therefore we are in discussion with the current staff about their future roles at WHP.

6.    Will I need to register with WHP?

We would ask patients to allow time for the formal process to take place. Once this has been agreed the patients will automatically transfer so there will be no need to go through a registration process.

7.    Can I register with WHP or another local practice now?

Although all patients have the right to register with any practice, if they are in the catchment area of that particular practice, we would suggest that you continue with PLMC whilst we go through the formal process. PLMC will continue to provide full medical services until a decision has been made by NHS England.

8.    Can WHP accommodate the extra patients?

WHP has a business plan in place and has reviewed its current building and staffing levels. We are confident that we have the capacity to accommodate the patients from PLMC and to ensure clinical care is not compromised.

9.    I am not in the WHP catchment area, can I still join the practice?

YES. After the formal process and with NHS England’s agreement all PLMC patients will automatically be registered at WHP. The WHP catchment only applies to patients not registered with PLMC.

10.    Who else has been consulted?

We have had 2 meetings with PLMC patients and have a third meeting planned on Monday 3rd July. Information has been made available on the website, in the practice, at local pharmacies and on prescriptions. Text messages have been sent to more than 4000 patients where we have mobile numbers. We have had a meeting with the WHP Patient Participation Group. We are also having discussions with all local pharmacies, local practices, community nursing teams, Health Watch, local Councillors, Local Medical Committee and the Clinical Commissioning Group.

Our proposal would enable  Park Lodge Medical Centre patients to be served from the WHP site and result in a combined population of 25,000 patients which would be aligned with the government strategy. NHS England’s report Next Steps on the NHS Five Year Forward View said this large model 'allows practices to share community nursing, mental health, and clinical pharmacy teams, expand diagnostic facilities, and pool responsibility for urgent care and extended access' and can work more closely with community pharmacists.

Our vision for WHP/PLMC is directed at developing a sustainable general practice organisation that delivers the highest quality of care, in the most efficient manner with excellent health outcomes and experience for our patients. Within the current climate there is uncertainty about the future of general practice and increasing patient demand for our services. However, Winchmore Hill Practice is an organisation which has a successful history of being able to adapt and provide high quality care to its patients. The on-going development of the organisation with a focus on working as smart as we can, improving skill mix and working collaboratively with other practices will ensure our continuing success.

We are very proud of our team. We are dedicated and committed to providing a first class service to our patients. We aim to treat patients as we would wish to be treated ourselves. We would define ourselves as efficient and friendly. We try to instil a stress-free but lively environment, which encourages the team to remain focussed and projects a positive attitude to our patients. We keep all our activities under review and are always looking for new ways to “work smarter” and to improve the quality of our services and care of our patients.

Dr R Noor
Dr C Sankaran
Dr R Parbhoo
Dr V Thiagarash
Dr T Takla

Source: Document supplied to PGC by the Winchmore Hill Practice on 30 June 2017

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