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Rethink on King's Lynn's St James House Surgery, Lynn News letters

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As it stands, the practice is cherry picking those parts that suits its agenda, but it does so at the cost, and while ignoring, the greater view.

According to the King’s Fund, the scope of STPs is broad. Initial guidance from NHS England and other national NHS bodies set out around 60 questions for local leaders to consider in their plans, covering three headline issues: improving quality and developing new models of care; improving health and wellbeing; and improving efficiency of services.

STPs include ambitions to improve care in specific services areas – such as cancer or mental health services.

NHS. (24107641)
NHS. (24107641)

STPs also give attention to the changes needed in NHS infrastructure – such as IT systems and NHS buildings – to support their ambitions to transform services, with growing pressures in general practice, district nursing, mental health, and adult social care. In this context, proposals in STPs to reduce capacity in acute hospitals will only be credible if there are coherent plans to provide acceptable alternatives in the community.

It is to the credit of the surgery that this consultation is taking place, but it does so at the behest of the STP, for the key priority for STP leaders in the short term is to strengthen involvement in the content of the plans – particularly among clinicians and other frontline staff, local authorities, and patients and the public, but there is absolutely no point in consulting with patients and the public unless the patients and public are listened to, heard, and accommodated.

The King’s Fund argues that STPs offer the best hope to improve health and care services despite having been beset by problems, and calls for a need to: secure the meaningful involvement of patients and the public in the plans. Meaningful involvement means listening to us, not going through a tick box exercise and then ploughing on with an agenda already decided behind committee room doors.

Mark Doughty, a senior leadership consultant at the King’s Fund, refers to an NHS communication that states, “STPs offer the best hope to improve health and care services despite having been beset by problems so far, and calls for a need to: secure the meaningful involvement of patients and the public in the plans” Meaningful involvement means taking note that when we say the relocation is unacceptable to the majority of frail, elderly, vulnerable people because it is inaccessible, we mean that the relocation means the frail, elderly and vulnerable patient population will be disadvantaged and discriminated by that decision.

He continues, “however, the danger is that under this pressure people can retreat into their professional and organisational silos and adopt practices that maintain control, rather than work towards change for the better”. I urge, on behalf of the vulnerable, frail, and elderly, that the surgery relinquishes the drive to retreat into the silo of “we are going to relocate whether you like it or not”, and use the money NHS England are prepared to hand over free for delivering the Five Year Plan, to accommodate the needs of those vulnerable who are best served by having access to a site within their range.

The NHS Five Year Plan Forward View Primary Care document (Improving Access to Primary Care Services), states that improving access to primary care services is a top priority for patients. The General Pratice Forward View set out a detailed, costed package of investment and reform for primary care now through to 2020. It will mean more convenient access to care. How can the surgery claim that its plans to relocate will be in keeping with the Five Year Plan when, far from making access to care more convenient, it makes it far more difficult by taking it out of the town centre and where the majority of the public live and work?

Where a GP surgery is needed is where the patients are, where the public are, not on a ring road heading out of town at its northern point, far from a bus service, where most of the patient catchment can’t get to see their doctors unless they have a car.

It is an ambition of NHS England that GPs will use the Electronic Frailty Index to better support the most vulnerable of patients by keeping them in the community, out of hospital work with people to maintain their independence. How will this happen if surgeries are so far removed from their patients that the relationship between patients and doctors deteriorates because patients can’t easily reach their doctors, because their doctors have relocated themselves to a site they can’t reach.

With specific reference to the points made by the surgery concerning parking, parking at the place of work is a luxury not afforded to the majority of the working population. Most people have to park at some distance from their desk. What is the problem with staff parking at the multi story car park and do as other do, walk for five minutes to the front door?

It isn’t a Health and Safety requirement that all employees have access to a window, otherwise staff working in an operating theatres, for example, would have downed tools long ago.

I do realise that you have looked at other options and decided that the proposed site is the only one, but the proposal to relocate to an inaccessible site for the majority of patients doesn’t fulfil the requirements of the NHS Five Year Plan nor the ambitions set out by the Sustainable Transformation Partnership.

Even if it means having a satellite service at the current building like there is for the population of Dersingham who can’t access Gaywood Road, I urge you to rethink.

Jeremy Dearling,

King’s Lynn

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