Agenda item

Proposed Merger of Norfolk Park and Dovercourt GP Practices

Report of NHS Sheffield Clinical Commissioning Group.



At the start of this item, questions were asked from members of the public and local Councillors as follows:-




Questions from Kim McMaster from Norfolk Park TARA




Why were patients misled? The Manor Top Clinic is earmarked for closure as it's not accessible to disabled patients, no parking, building is in disrepair, dangerous to cross East Bank Road etc.




Why were we told Manor and Castle Development Trust (M&CDT) had been appointed at the beginning of the process when they were not actually in place until over halfway through the consultation?




Why are we being consulted on a done deal, doctors have already quit their lease before consultation started?




The patients of Norfolk Park are not happy with the proposals to merge and close our state-of-the-art building, and would prefer that the surgery became a satellite of Dovercourt and have doctors in there five days a week. (This has been done with another surgery locally).




How are patients with no access to transport supposed to get to Dovercourt?




In response, Abigail Tebbs, Deputy Director of Delivery, Primary Care Contracting, Digital and Estates, NHS Sheffield Clinical Commissioning Group (CCG) stated that as a result of the feedback on consultation and other work ongoing, the CCG would be stopping the consultation to show patients a revised proposal which would involve the merger still going ahead, but services would still be provided at Norfolk Park. She said she didn’t have all the information available, but the same clinicians would be available at both practices.






Questions of Councillor Ben Miskell




The surgery itself is located in 8-year-old premises and is owned by Community Health Partnerships Ltd (CHP), a private company, wholly owned by the Secretary of State for Health and Social Care.


Given the ownership arrangement of the building, can representatives from the CCG confirm to Members of the Committee, that should the surgery close, the CCG and thus the taxpayer will still be liable to pay the rent on the empty space that is left?


Could the CCG also confirm the total cost that this would represent to the taxpayer for the ongoing rent of empty space in this building?


Can the CCG also confirm whether the GPs acted on the advice of the CCG in tendering notice to the landlord, prior to the commencement of the consultation period. As members of this Committee will understand, this action by the GPs, has caused significant resentment in the local community and concern that the consultation itself is a done deal.


If this is not the case, what action has the CCG taken with the landlord to investigate how services can continue to operate from the Norfolk Park premises in whatever form, given that notice has already been served to vacate the building?


As Committee members will have heard from Kim McMaster from Norfolk Park TARA, there are some serious concerns about the consultation itself. It commenced during a period where face-to-face contact was limited due to the pandemic. Stage 3 covid restrictions stayed in place for a further month, preventing full discussion of the issues and in particular excluded those from protected groups.


Moreover, Manor and Castle Development Trust was appointed only halfway through the consultation period to engage with community groups. Given this information, I am asking on behalf of the community that this Committee recommends that the consultation period for this proposal be extended.


I am also asking that the Committee use its powers to recommend against the proposal to close Norfolk Park Surgery, which will only serve to widen health inequalities in the area and will potentially create significant additional cost to the taxpayer, who will have to continue to pay for an empty building, whilst residents are denied their own local GP practice in Norfolk Park.




Questions of Councillor Sophie Wilson




Councillor Wilson referred to the petition and questions that have been submitted and asked at the two previous meetings of Full Council and the strength of feeling around this.  Councillor Wilson raised questions around the proposed merger and the proposals to include the Manor Top Surgery.  She said that concerns had been raised regarding residents in the Norfolk Park area travelling to the Dovercourt and Manor Top Surgeries and the potential problems this would create.  Councillor Wilson also said that most residents had received the information regarding the merger via text message initially and then by letter.  She expressed concerns that Councillors and health partners had not been able to hold face to face consultations with residents due to the pandemic and asked for the consultation to be extended by one month.




The Chair stated that he would respond to the questions during discussion on the item and thanked the questioners for attending the meeting.




The Committee received a report of the Director of Commissioning and Development, NHS Sheffield Clinical Commissioning Group regarding the proposed merger of Norfolk Park Health Centre with Dovercourt and consultation on the proposed closure of Norfolk Park Health Centre.




Present for this item were Abigail Tebbs (Deputy Director of Delivery, Primary Care Contracting, Digital and Estates, NHS Sheffield Clinical Commissioning Group (CCG)), Lucy Ettridge (Deputy Director, Communications, Engagement and Equality, NHS Sheffield CCG) and Dr. StJohn Livesey (Clinical Director, NHS Sheffield CCG).




Abigail Tebbs again reiterated that as the result of the feedback on consultation and other work ongoing, the consultation had been paused and a revised proposal would be shared with patients.  She said that the merger would still go ahead, but services would continue to be provided at the Norfolk Park Practice. Ms. Tebbs said she didn’t have all the information available, but the same clinicians would be available at both practices. She felt it was important to highlight the way the proposals work and the process that they go through.  As independent contractors, general practices can make applications to the CCG to merge and/or close practices and the CCG has a duty to consider those proposals, taking into account a number of factors when making the decision.  The CCG then has to develop and consider the proposals, go through the appropriate public consultation and submit the application for consideration by the CCG’s Primary Care Commissioning Committee (PCCC).  In this case, the Committee has to consider what was best for the patients of the Norfolk Park practice and determine the health needs of those in that area and then decide whether or not to approve the application.  With regard to the Manor Top Clinic, patients in the area were informed by letter and text message, that the longer term future of that Clinic would be the subject of further review, but it was not part of the proposals for this merger.  The decision taken by GPs to terminate their contracts was not taken on the advice of the CCG, but it was communicated that any decision to terminate contracts would be supported when the lease of the Norfolk premises was surrendered.    The owners of the premises, Community Health Partnerships Ltd (CHP), require the approval of the CCG to surrender the lease of the premises and as yet, the CCG has not given such approval for that.  Ms. Tebbs stated that it was recognised that Norfolk Park was a good asset with excellent health care facilities, and there was a desire to see buildings of this nature being fully utilised.




Dr. Livesey stated that many GPs were at breaking point and often asked how much longer they were expected to carry on working under the conditions they do.  He felt that the merger gave them the chance to be able to attract and retain doctors, something that hadn’t been possible for a number of years.  Dr. Livesey felt that the merger would give staff a feeling of security.




Abigail Tebbs then referred to the total amount of void space used at Norfolk Park and stated that a percentage of sessional space, e.g. consultation rooms, waiting rooms, etc. was completely unallocated.  She said that the CCG was responsible for funding for the void space as well as rental costs and said that there was no overall cost increase for unoccupied space.  She said she had had discussions with NHS Property Services and as yet approval had not been given for the termination of the contract.  Consultation had been difficult during the pandemic but due to the timing of the request, the CCG had to continue with the consultation and the proposal had the full 12 week consultation period, and letters had been sent before text messages but there was only a matter of days between these platforms being used.  It had not been possible to hold face to face public meetings as this would have delayed the consultation period, however that period was now to be extended.




Members of the Committee made various comments and asked a number of questions, to which responses were given as follows:-




·                Information around the demographics of the local population and the longer term strategic and population growth in both the Norfolk Park and Dovercourt areas would have been submitted for consideration.  The CCG would also consider what the impact on the quality of services would be should the merger go ahead and if there were any concerns, the CCG could ask for further work to be done or reject the proposal.  The CCG was aware of increases in housing  and future plans for that area, and part of the primary care planning was to ensure that there was sufficient primary care on offer in the future.




  • GPs were contracted and independent, but the CCG does provide support to GP practices and provide leadership and support to ensure there was sufficient quality of services in Sheffield.  There was a responsibility to ensure that a robust service was available in the area.  It was stated that new models for working practices were emerging and it was time for change.




·                The CCG has a responsibility to assess patient needs.  There was no guarantee that if the contract were to be retendered there would be any interest from other providers.




·                In terms of the impact on the Dovercourt surgery in terms of location, in approving any merger the PCCC would wish to be fully assured that the two practices were fully equipped to meet the demands placed on them by the emergence of larger practice lists.  Norfolk Park was a very successful practice and successful in recruiting to their practice.  What was presented in the application, was an assurance that the merger would provide both GP services simultaneously with good levels of support and more stability to both practices.




·                Discussions were due to continue during the following days, and there was a need to ensure that the information available following such discussions was made very clear to all concerned.




·                The GPs were the key drivers in this as the GPs at Norfolk Park felt they were unable to continue alone with the leadership model they had in place, that the practice was no longer sustainable, and the merger would bring stability to them.  There were no plans for net loss of GPs as a result of the merger. GP hours would be more likely to increase not lessen.  It would be wrong to say at this stage that there would be no reduction in GP hours, but the merger would make it easier to be able to recruit.




·                There were no plans at present to close the Manor Top Clinic. Due to the very nature of the layout and accessibility of the building, the future of the Clinic could be reviewed in the future, but to include it now as part of this merger, would delay the whole process and the ambition was to complete the merger as soon as possible to offer stability to both practices.  It was recognised that this had been a worrying time for patients and there would be nothing to be gained by changing things now.  Discussions have been held regarding the future of the Manor Top Clinic and this would be addressed in the future.




·                Both Practices already offer extended hours. Hours at the Dovercourt practice were earlier in the morning and opened later in the evening than at Norfolk Park. Patients of the merged Practice would be able to take advantage of those services on offer at Dovercourt, but details around this still needed to be determined.




·                NHS England have received complaints from patients not being able to see their GP, even before the pandemic, but GP practices nationally were in a very difficult position in attracting and keeping GPs, so there was a need to make sure there are strong foundations in place and try to find solutions and also ensure that Sheffield can attract more GPs to the area. 




RESOLVED: That the Committee:-




(a)      thanks Lucy Ettridge, Abigail Tebbs and Dr. Livesey for their contribution to the meeting; and




(b)      notes the contents of the report and responses to the questions raised.






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