Proposed changes to Health Services

Date created: 1st August 2011

Created by: Michael Hart (Practice Manager) on behalf of Dr Brahma & Partners.

Introduction

Our main practice, Ash Grove Medical Centre is just 18 months old and is on England Lane, Knottingley. We also have

two branch surgeries, one at Eggborough and one in Ferrybridge. We have 13,037 patients as at July 2011 and nine

GPs working across all three practices. From our main practice in Knottingley we offer a range of services including

Ultrasound, podiatry, nurse led clinics, minor operations and chronic disease management.

Why the proposal to close Ferrybridge surgery?

Our aim is to ensure that all of our patients are seen in modern, comfortable surroundings which are suitable for and

accessible by all. The surgery at Ferrybridge is located in a converted council flat which is in very poor condition. It is

owned by Wakefield Council which means we are unable to make changes required to meet the minimum standard

we feel patients and staff deserve. Particular areas of concern are that it:

- Does not comply with the disability discrimination act (DDA). - Has no central heating - Has no dedicated parking availability - Has inadequate toilet facilities for both staff and patients. - Has nowhere for patients to discuss confidential information with reception. - Has no room to expand to offer nurse led clinics.

General practice information

Opening times of Ferrybridge branch, Argyle Road

Monday 08:30-11:00

Tuesday 14:30 – 17:30

Wednesday Closed

Thursday 08:30-11:00

Friday 14:30-17:30

Purpose of use of Ferrybridge Branch

- The branch site is used for GP consultations only and dealing with patient queries via reception.

- Other services available – Ordering of repeat medication.

Number of patients who use the branch site under categories

Repeat prescription service

On average there are 120 repeats ordered via Ferrybridge branch site on a weekly basis.

GP Appointment

Just over half of the appointments in any one clinic are utilised by Ferrybridge residents and the remaining

appointments are patients who reside outside the area.

Appendix 8 provides some statistical information on the appointments utilised at all 3 sites.

Opening times of Ash Grove Medical Centre (Main site)

Monday 08:00-18:30 (Early surgery 07:00-08:00 and late surgery 18:30-20:00) (Appt. only)

Tuesday 08:00-18:30(Early surgery 07:00-08:00 and late surgery 18:30-20:00) (Appt. only)

Wednesday 08:00-18:30

Thursday 08:00-18:30 (Late surgery 18:30-20:00) (Appt. only)

Friday 08:00-18:00

Opening times of Eggborough branch site

Monday 08:30-12:00 14:30-17:30

Tuesday 08:30-12:00 14:30-17:30

Wednesday 08:30-12:00 14:30-17:30

Thursday 08:30-12:00 14:30-17:30

Friday 08:30-12:00 14:30-17:30

Practice List size 13,037 as at July 2011

Impact of moving services from Ferrybridge to Knottingley

Patients who currently utilise Ferrybridge surgery would benefit from having all services under one roof. Health

visitors and District nurses use our premises which means patients no longer have to use Hazel Road clinic. Since

opening the new health centre on England’s Lane we have an excellent service being provided and a varied number of

outside providers work from our premises including:

- Ultrasound

- Podiatry

- Substance misuse services

- Citizen advice service

- Physiotherapy

The practice also runs an exemplary nurse led service for chronic disease management, phlebotomy clinics and a

variety of of GP appointments including telephone consultations, specialised clinic and, general appointments which

are available up to 5 weeks in advance.

Additional services being provided at the main surgery with this proposal

Increase in telephone consultations, and general appointments being utilised at Knottingley with the time saved on

travelling between surgeries.

Nearest GP Practice

Dr Pinder and Partners is located within a 2 minute walk from the branch site. Appendix 1 details the location of the

following:

- Pharmacies near by

- Nearest GP Practice (Dr Pinder and Partners)

- Our branch site on Argyle Road

- Our main surgery on Englands Lane

Stakeholder contact prior to start of consultation period

The Practice made contact with Ferrybridge surgery (Dr Pinder & Partners) verbally to inform them of the proposal

prior to the leaflet being sent out to patients.

The PCT contacted the following recipients to inform them of the consultation process, (copy of email below).

Contacts: 'brhodes@wakefield.gov.uk' 'jan.morris@wakefieldha.nhs.uk';

'raj.aggarwal@blackberry.orange.co.uk''Celia Bateson'; Earnshaw Phillip (WDPCT);

'coopery@parliment.uk'; 'gdoyle@wakefield.gov.uk'; 'gburton@wakefield.gov.uk';

'gstokes@wakefield.gov.uk''coopery@parliament.co.uk'; 'hellis@wakefield.gov.uk'

Copy of email sent to all of the above:

Attachments: 010868_Ferrybridge.pdf final (Attachment is of the final leaflet sent out to patients)

I am writing to inform you that Ashgrove Medical Centre is about to start a 10 week consultation on proposals to close their branch surgery in Ferrybridge. If it goes ahead it will mean the transfer of patients and services to their main surgery which is based less than 1.5 miles away in Knottingley. The practice will be writing to all households affected by the potential closure giving them information about the proposals and asking for their feedback. In addition they will be holding a public meeting on the 9

th July so that the public and patients can get

further information and ask questions: I have enclosed a leaflet which outlines the reasons for the proposed closure. If you would like any further information or have any questions then please do not hesitate to contact me. Yours sincerely Ann Ballarini Director of Strategy

NHS Wakefield District White Rose House West Parade WAKEFIELD WF1 1LT

Consultation methods used

10 weeks was allocated to run the consultation process. The practice worked closely with the patient reference group

and a steering group was developed with 2 members of our PPG group on the panel. The steering group was used to

discuss and plan out the consultation action plan.

The following consultation methods were used to inform patients of the proposal and collect feedback.

Press Release and Ridings FM – To ensure all patients were aware of the proposed closure a press release went out

in the local paper (Pontefract and Castleford Express) and it was raised on local radio (Ridings FM). (Appendix 9

shows the article used in the press).

Leaflet – A leaflet (see separate attachment) was used to obtain feedback from patients. 1,100 were sent out to

patients who reside in the Ferrybridge area. (Appendix 2) provides details of the feedback received from the leaflets

including percentages.

Posters in main practice and branch sites – The proposed closure was advertised within the main surgery and the

branch sites via posters and dedicated notice boards.

Public Meeting– A public meeting was organized on the 9th July 2011. Patients had the opportunity to attend and

give their views and raise questions. (Appendix 3) provides the feedback from this meeting. This was well advertised

including, press release, ridings FM radio, posters being displayed in local shops and flyers being given out to

patients of Ferrybridge during the morning of the public meeting. (Appendix 4)

Stall at carnival – Prior to the public meeting we had a presence in Knottingley carnival. One of our patient

representatives had leaflets to hand out and gave patients the opportunity to give feedback on the proposal.

Community group – Practice representatives attended the over 60’s group at Ferrybridge community centre to

allow patients to air their views on the proposal. (Appendix 5) gives feedback from this meeting.

Meeting with local MP Graham Stokes (June 11)

During the consultation period a meeting took place at the branch site between the Practice Manager and the MP

(Graham Stokes. The proposals were discussed.

Feedback from patients with action plans attached.

The following lists are issues that patients have raised either via the leaflet, public meeting or community groups.

Under each section there are details of what action the practice has taken or will take in the near future.

Transport

Patients have a major concern for the lack of public transport between Ferrybridge and Knottingley. There is currently one bus per hour (188). The route taken by this bus does not cover a large area and patients residing in Nevison are affected.

Action taken: The Practice Manager emailed the appropriate person within the bus service (appendix 6) A meeting took place with a representative of Metro on 29th July 2011 (appendix 7) Outcome Metro are looking into the bus service and will discuss route changes with Arriva and M travel with a view to re-routing some services to accommodate patients who reside in the Ferrybridge area. If the bus service cannot be re-routed the practice will review its appointment system to attempt to accommodate patients who are limited to certain times of the day due to bus times.

Repeat Prescriptions

Patients were concerned that they will have to travel to Ash Grove to order their repeat medication. Action taken: Patients have a number of options available to them to order their medication which does not require a patient to attend the practice. These include:

- Via the internet - Via post - Via Telephone to the main surgery on our dedicated prescription line (01977 622104)

The prescription line number and our main phone system is being reviewed to ascertain whether a different provider can provide a cheaper call for patients. A meeting has been organized with Premier telecom taking place on the 27th October 2011. The outcome from this meeting will be fed back to the PCT.

How feedback will be given to patients

If the closure is approved the practice propose to give patients 3-months notice of closure from the date of

approval. The following methods will be used to inform patients:

- Practice internet

- Practice newsletter

- Poster form within the practice, branch sites and shops and community centre within Ferrybridge

- Local papers and radio.

Appendix 1

Appendix 2

Feedback from Leaflet

As part of the consultation process the practice sent out 1,100 patient leaflets informing patients of the main reasons

for the proposal and asking for their feedback asking the following question:

Question 1: Do you agree with the proposal to close the Ferrybridge branch surgery?

8% of patients who said yes.

7% of patients who said no. (If no the reasons why).

85% no response Patients who said no gave the following reasons:

NO - please tell us why: Numbers

Transport problems (including distance, bus service

and cost) 65

Concerns regarding telephone service at Knottingley

(cost and length of time calls answered) 3

Waiting time for appointments 2

Concerns regarding system for repeat prescriptions 3

Patients simply don’t want change 5

Concerns regards car parking spaces at Knottingley 1

Quotes of people who have said yes:

“I think it is time to change to Ashgrove Surgery because of all the inconvenience especially if you are disabled. I

think it is a very good surgery at Ashgrove, you can get your prescriptions on the premises”.

“Ashgrove Medical Centre is more suitable and has everything you need there”.

“As a Ferrybridge resident I have only used the Argyle Road surgery twice. I prefer the attend the new Ashgrove

Surgery with all its first class facilities”.

“Agree on the proviso that there will be an extra GP at Ashgrove available. I can often get an appointment at

Ferrybridge but not at Ashgrove”.

“Agree but you need to revise your “ample” parking spaces at Ashgrove as sometimes it is impossible to park now,

never mind when you close Ferrybridge”.

“I think the surgery should close due to the points raised but my concern is would the extra appointments which are

available at Ferrybridge be available at England Lane or is it another cut back which will result in increased

appointment times”.

Quotes of people who have said no:

“After making enquiries on how to get to Ashgrove Medical Centre it would create a problem for me. I have now

joined Dr Pinder & partners in Ferrybridge.”

“How is England’s Lane going to cope with the extra calls? It already takes ages on a premium rate number to get

connected. I live on Fryston Lane and the only bus is the 188 which is very unreliable and only runs hourly.”

“I don’t agree because it is hard for those of us in Ferrybridge who can’t walk far. There is only one bus every hour.”

“This will cause considerable hardship to the elderly and infirm in Ferrybridge. If the hourly bus service doesn’t

coincide with appointment time it could take 2-3 hours for a 10 minute appointment. Waiting time is less at

Ferrybridge than Ashgrove”.

“When I am ill and need to see a doctor I don’t need the Hilton or 5 star environment just to see a doctor”.

“For some people it will mean the cost of bus fare or petrol to visit a doctor. A lot of people are on low wages and

cannot afford the additional cost. I have attended Ashgrove and had to park on the road because the car park was

full, this is not fair on residents. Patients may not feel well enough to travel to Knottingley and this may result in

more home visits”.

Appendix 3

Feedback from Public meeting 9 July 2011 – Potential branch closure Ferrybridge

In attendance:

- From the practice, Practice Manager, 6 GPs.

- 9 patients attended the meeting.

The following issues were raised at the meeting where there were 6 GPs, Practice Manager and a representative

from the PCT present to answer questions.

Transport

It would take more than one bus to get to Ashgrove Surgery from Ferrybridge

A lot of older people in Ferrybridge cannot afford to pay for a taxi

Is there a community bus Answer

Understand £6 is a lot of money to pay – we acknowledge that it is difficult to bring services to people’s doorsteps - however we have to realistic.

Will talk to arriva to see if anything can be done to alter the route and frequency of the bus service. Will also look into whether it would be possible to book appointments for people who are travelling by bus from ferrybridge to coincide with the bus times.

There is a community bus but there is a charge (cheaper than a taxi) but people with free bus passes would have to pay

Prescriptions

Will we have to travel to Ashgrove surgery for our prescriptions? Answer

No – The branch surgery is used a lot for people dropping and picking up prescriptions. We are looking at having a secure box in Ferrybridge where residents can leave and pick up their prescriptions. We also run a home delivery service. There is no need to for anyone to have to attend Ashgrove surgery to pick up their medication or drop off their prescription

Complaints about the branch surgery

Has the practice received any complaints about the branch? Answer

Confidentiality has been an issue. Patients in the waiting room can hear discussions within the consulting room.

Temperature – complaints it is too hot in summer and too cold in winter Telephone appointments

Will you be able to offer telephone appointments? Answer

Yes we will be able to do that. We will also have more time to do other things, i.e., home visits

Appendix 4

Proposed changes to GP services in Ferrybridge

by Dr Brahma and Partners

Public meeting at:

Ferrybridge Community Centre

The Square

Ferrybridge on:

Saturday 9 July from

4pm – 6pm

This is your chance to tell us what you think

about our proposals to close the branch surgery

in Ferrybridge.

Come along and ask any questions.

Appendix 5

Feedback from meeting with the ‘Over 60’s’ group in Ferrybridge 14 July 2011 – Potential branch closure

Ferrybridge

In attendance:

Dr Tim Dean – Partner Ashgrove Surgery

Michael Hart – Practice Manager

Helen Butters – Engagement Manager Wakefield District PCT

General public – Approx 15 people.

Main Headlines

Transport

There is only one bus an hour – are we able to have appointments to coincide with the bus times? Answer

Ashgrove Medical Practice is currently in talks with Aviva to look into this issue. We will also look into appointment times.

Prescriptions

Will we have to travel to Ashgrove surgery for our prescriptions?

Answer

No – . The branch surgery is used a lot for people dropping and picking up prescriptions. We are looking at having a secure box in Ferrybridge where residents can leave and pick up their prescriptions. We also run a home delivery service. There is no need to for anyone to have to attend Ashgrove surgery to pick up their medication or drop off their prescription

Building

Why can’t you find another building in Ferrybridge?

Answer

Ashgrove aims to provide high quality care for patients in Ferrybridge. A room with a receptionist and one doctor is not good enough. Even if we were to find another site, the service we would be able to provide would not be as good as at the main branch in Knottingley.

Appendix 6

From: Hart Michael [mailto:michael.hart@wdpct.nhs.uk]

Sent: 20 July 2011 11:21

To: Neale Wallace

Cc: Butters Helen

Subject: Bus service between Ferrybridge and Knottingley

Dear Neale

Just to introduce myself, my name is Michael Hart, I am a Practice Manager of a busy Doctors practice in Knottingley.

We are currently in a consultation process with patients from Ferrybridge, West Yorkshire looking at closing our

branch site from there. One of the main issues that patients have raised is the lack of buses from Ferrybridge to our

practice in Knottingley (Spawd Bone Lane). I am being told that the only bus that runs from Ferrybridge square is the

188 and this runs once per hour and does not go through Nevison, Pontefract.

I am aware that there are a number of buses that run around the village of Ferrybridge including the 148, 149, 150

service but unfortunately these buses do not either pass our practice on Spawn Bone Lane, Knottingley or do not

attend Ferrybridge Square.

My question is this, would it be possible to hold a discussion with you to review whether some of these buses could be

re-routed to accommodate Ferrybridge patients to allow them to be dropped off outside the surgery?

If we could discuss this matter in more details I would appreciate it if you could give me a ring on the contact number

provided.

Kind Regards

Michael Hart

Practice Manager

Ash Grove Medical Centre

Dear Michael, thanks for getting in touch.

For background, services 148 and 150 are operated on a commercial basis by Arriva Yorkshire in the main without

any subsidy from Metro. This means that any decision to re-direct these services would be a commercial decision by

them.

The 188 is subsidised by Metro. Metro is severely restrained by funding cuts as are most local authorities and would

not be in a position to increase the level of service and therefore subsidy on this route. Over the next couple of years,

the likelihood is that Metro will be cutting some tendered services rather than enhancing them although the 188 is

likely to remain on its current frequency.

On a positive note, Metro has a great deal of expertise in service planning and working creatively with operators and

partners to find innovative solutions. We are quite happy to approach Arriva and see if amongst us we can do

anything that helps, but clearly this is not guaranteed. It would also be useful to know if any funding is available from

yourselves. I have asked Clive Hopkinson our Bus Delivery Team Leader (who is cc’d) to contact you direct and discuss

with you in detail your requirements. He will also liaise with Arriva and see what, if anything, can be done.

Finally I note that when you telephoned you said that you had been trying to get hold of me for ages. I am a little

perplexed by this as I have not received any messages other than today. Can I ask what number you phoned and who

you spoke to?

Kind regards neale

Appendix 7

Meeting regarding Bus service at Ferrybridge to Knottingley

Meeting with: Clive Hopkinson, Metro

Date: 29th

July 2011

Topic: Different bus services residing around Ferrbridge

Discussed the different bus services between Nevison area, Ferrybridge and Knottingley (England’s Lane area).

The 188 – (Operated by Arriva) - Is hourly, from Stranglands Lane and Ferrybridge Square and passes near to the surgery on

England’s Lane.(runs via Spawd Bone Lane). Unfortunately this service doesn’t run through Nevision .

The 149 – (Run by Arriva) - Runs half-hourly along Pontefract Road and bypasses Ferrybridge but passes our practice on

England’s Lane . Metro will discuss the service with Arriva to evaluate whether the 149 can be diverted via Ferrybridge Square

and possibly serve Nevison.

The 489 hourly, off-peak only – Similar route as the 149. The 489 is run by M Travel.

The 150 – (Arriva ) – half-hourly. Serves Ferrybridge Square and terminates at Broomhill Avenue off Womersley Road.

The 487 and 488 (each hourly off-peak) run from Ferrybridge but terminate at Common Lane off Weeland Road (487), or

Broomhill Avenue (488). (Operated by M travel).

Action plan

Clive will approach Arriva and M Travel to discuss the findings from the feedback from Ferrybridge residents to ascertain whether

any changes to the bus services can be made in order to serve the new practice, particularly from the Nevison area.

Appendix 8

Appointment branch Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Ash Grove 6329 5581 6495 5269 5970 6049 5375

Ferrybridge Surgery 185 159 201 173 120 140 178

Whitley Bridge Surgery 676 667 738 598 702 689 675

Appointment branch Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Ash Grove 88% 87% 87% 87% 88% 88% 86%

Ferrybridge Surgery 3% 2% 3% 3% 2% 2% 3%

Whitley Bridge Surgery 9% 10% 10% 10% 10% 10% 11%

APPENDIX 9

News Release

27 May 2011

Knottingley GP practice proposes closure of Ferrybridge branch

Ashgrove Medical Centre in Knottingley is proposing to close its Ferrybridge branch surgery on Argyle Road and

transfer the services to its main site on England Lane, Knottingley.

As part of the decision-making process, there will now be a three-month period of engagement with patients and local

stakeholders to discuss the proposals and seek their views on the proposal to close down the branch surgery.

The current surgery at Ferrybridge is provided from a converted council flat which is in very poor condition. As it is

owned by Wakefield Council, the practice is unable to make the changes required to meet the minimum standard that

patients and staff deserve. Particular areas of concern are that it:

oes not comply with the Disability Discrimination Act (DDA);

has no central heating;

has no dedicated car parking available;

has inadequate toilet facilities for both staff and patients;

has no where for patients to discuss confidential information with reception staff; and

has no room to expand to offer nurse-led clinics.

Dr Dean, Ashgrove Medical Surgery said: “Our aim is to ensure that all of our patients are seen in modern,

comfortable surroundings which are suitable and accessible by all. We believe we can do this much better by

transferring the Ferrybridge services to Knottingley.

“Anyone who has been treated at the Ferrybridge surgery will know that the facilities are very poor and as we do not

own the building, adapting and updating the premises is problematic.

“We will be writing to all those patients registered with Ferrybridge as part of a three-month public engagement

exercise to make sure patients are fully informed about their options. We know our Ferrybridge patients may have

concerns about these proposals, so as well as writing to them we will also be holding an open evening where they

can come along and ask questions.”

The public open evening will be held on Saturday 9th July at Ferrybridge Community Centre, The Square, Ferrybridge

between 4pm and 6pm.

The public engagement exercise started on 25 May 2011.

Patients and members of the public can participate by:

Completing and returning the form on the back of the consultation leaflet (available from the surgery);

Writing to: The practice manager, Ashgrove Medical Centre, England Lane, Knottingley; or

Emailling PALS@wdpct.nhs.uk.

Ends

Issued by Amanda Dissanayaka, External Communications Officer on 01924 317647.

Follow us on Twitter: www.twitter.com/nhswakefield

Note to Editors

NHS Wakefield District

1 NHS Wakefield District is responsible for commissioning health services across Wakefield, the five towns, and

their surrounding communities. This includes community-based health services such as district nursing, health

visiting and podiatry. NHS Wakefield District also oversees the work of GPs, dentists, opticians and pharmacists,

and is responsible for commissioning mental health, hospital and other specialist services on behalf of local

people.

2 In addition NHS Wakefield District carries out a wide-range of health promotion aimed at helping to improve the

health and well-being of local people.