On Friday we received two letters at our house, one from our GP surgery and one from The Leicester City Clinical Commissioning Group.
The letter from the CCG said that my GP (Dr. Lenten) ‘wishes to terminate his contract’. This means that as of 31st March 2016, all Dr. Lenten’s patients will have to find new medical practices to go to as, because it is a single GP surgery, the practice will close down. They are sorry and the word ‘unfortunately’ is used a lot.
The letter from Dr. Lenten says the same thing,
‘It is with an extremely heavy heart that I find myself having to write this letter to you. It was always my intention to continue the practice for at least the next ten years, and to have been put in this position is heart breaking.’
When you read between the lines, it seems clear that Dr. Lenten does not wish to terminate his contract. It seems that he has been put in a position where he has no choice but to do just that. He is being very diplomatic in the way he words this, as he quite rightly, will still need to work for the next ten years, and work with and for the body that are now pushing him out of his practice.
It will mean the redundancy of all the surgery staff, and 2,400 patients looking for a new practice to join.
The discrepancy between the two stories piqued both our anger, and our curiosity and Jason set out to investigate, with a meeting with the surgery practice manager.
It transpires that Dr. Lenten has been battling to keep the surgery open for 18 months, but has been blocked at every turn by the CCG.
They argue that his practice is not financially viable. He has asked to be able to expand the surgery, and has room for another GP. Figures show this could make the surgery viable, and there is another surgery yards from Dr. Lenten’s that operates with two GP’s at double the patient numbers Dr. Lenten has, and which, as yet, is not under threat. This could be used as a viable economic model to do the same at our surgery.
Despite this, they have still refused him.
This is the third practice in our area to close since the end of last year. With the patients from Dr. Lenten’s surgery, plus a surgery that closed today, and one which closed at the end of last year that makes 15,000 patients who have had to or will have to find new practices.
The CCG say that the areas existing practices can soak up the numbers and that there are no waiting lists at any surgery.
The master plan is apparently to eventually divide the city up into five sections, which will in time be served by super surgeries. This means that there are more closures in the works.
One surgery which is under threat of closure, is one that patients of Dr. Lenten have been suggested as an alternative to register with.
I spoke to a woman today whose aunt was registered with one of the surgeries that closed before Christmas. She registered with Dr. Lenten, and is now being forced to look for another GP. How many more people is this happening to? How many more people will it continue to happen to as further surgeries close?
What concerns me is how patients who need joined up care will fare with this kind of atmosphere, and the constant moving from pillar to post. What concerns me is what happens to medical records that are constantly being transferred, new doctors who are always having to be filled in on the background of long term conditions etc? What happens when people start falling through the cracks, when things get missed? Things can go really wrong. People can, and I am not being over dramatic here, die in situations like this.
We did a little more digging over the weekend.
We found that one of the members of the CCG has a competing surgery in the local area. This is also one of the surgeries that we soon to be ex patients of Dr. Lenten are being urged to sign up with. It is currently expanding its practice.
We then looked at GP stats, which are freely available on the NHS website and which help you to pick a new GP if you are new to the area, or have to move GP for other reasons.
Dr. Lenten has the highest satisfaction score of any GP in our area, scoring in the high eighty and ninety percents across the board. One of the practices we are being asked to consider as an alternative has scores in the fifties. It scores worst on patients being able to make appointments. His surgery is twice the size of Dr. Lenten’s, but as he has two GP’s. He is being allowed to stay open, despite being rated as less than satisfactory.
Dr. Lenten is not being allowed to hire a new GP or extend his practice. The CCG state that their aim is to be ‘compassionate and caring.’ They also say that their mission is to make ‘effective use of resources’ to ‘provide the best possible care for our patients.’ This is not what I am seeing here. Why are they bent on closing down one of the most popular practices in the city, one, which I am informed, other GPs choose as their own GP, when they are continuing to support surgeries people are actively dissatisfied with?
The CCG argue that there are 23 surgeries in our area, which is too many. Our search threw up 15 surgeries within a 4.5 mile radius of us. Of those, two are now closed, ours is included in that list and is going to close, and one more is at imminent risk of closure. I have no idea how many more are scheduled for closure, but I imagine it’s more than a few given the super surgery idea. We also have no idea of time scales, so trying to choose a practice that will remain open is a bit of a lottery.
The arguments from the CCG are all about economic factors. They are cloaked in nice language, and sympathy, and the dulcet tones of their mission statement which puts the patient first, but this is not actually what is happening here. I appreciate that economic factors are big drivers, but there is still so much waste in other areas of the NHS, areas where money can be clawed back, why take it from valued and valuable front line services?
Dr. Lenten is the third generation of his family to practice medicine in Leicester. He has worked in our community for over twenty years. If you take into account his ancestors, his family have been serving our city for seventy five years.
Dr. Lenten knows all his patients. He cares about all his patients. Over the last four days, so many people have told me about the things that he has done for them that are above and beyond what you would expect of GP care. I have not heard a single bad word said about him. I am constantly hearing about his ‘excellence’, that he is the ‘best GP I’ve ever had’, that he has the time for all his patients, and that he listens to every one of them.
He is one of the best examples of what the NHS has to offer a community. He looks after his patients with old fashioned courtesy and he believes in a duty of care.
We should be modelling his practice, not shutting it down.
I thought about not blogging about this. How many of you, after all, are even local to me? Why would you care?
Then I thought: this isn’t just about Dr. Lenten. There is the wider picture. There is the bigger story. This story, my tiny story, is happening all over this country to all kinds of good GPs and all kinds of loyal patients. It is happening to communities everywhere, and we are sitting and watching everything that is positive and good being stripped away.
We sit, and we shake our heads, and we say: ‘It’s a shame, but there’s nothing we can do about it.’
There is something we can do about it. There is as long as we come together, and we talk, and we share, and we protest and we go to meetings and we speak out.
You can sign my petition, not because the loss of my doctor’s surgery is any more or less important than the loss of yours, but because it may have been you, it could be you next, and if you stand with me, I will stand with you.
You can help me think of ways that we can make our surgery viable, because it could be you next, and these ideas travel. What works for me, might work for you.
You can speak out to your own MP about cuts in your area. You can lobby pressure groups. You can speak to 38 Degrees and your local Healthwatch. You can go to meetings.
You can stop our country from being all about money, and start it being all about community. Let’s come together in the name of the things we care about.