1. Background

Lansbury Park and Troed y Bryn (Penyrheol) GP surgeries in Caerphilly have closed as of 1 May 2020.

The Aneurin Bevan University Health Board (ABUHB) website reported that patients of Lansbury Surgery had been informed that Dr Fakande would be resigning from his General Medical Services Contract with effect from 30 April 2020. As a single handed GP, Dr Fakande was required to provide a three-month notice period. Troed y Bryn Surgery is a branch of the Lansbury Surgery and Dr Fakande was also the sole GP at this practice.

The Health Board stated that it would ensure that all patients registered with Lansbury Surgery will have access to a GP practice from 1 May 2020 and Dr Fakande would continue to deliver General Medical Services to patients as normal until the contract ended on 30 April 2020.

The Health Board’s Vacant Practice Panel met on 24 January 2020 to discuss the options available. It was agreed that the practice would be advertised nationally, with the aim of recruiting a new GP contractor to continue providing GP services to the patients registered with Lansbury Surgery. Letters were issued to patients explaining this. Drop-in sessions were organised at Lansbury Surgery for patients to discuss any concerns they had with a Health Board representative.

ABUHB failed to find a replacement for its retiring doctor through national advertising which means the 3,962 patients registered at the surgery have been relocated to other surgeries nearby. A Wales Online articlein March 2020 states that patients at the Lansbury Surgery will be dispersed across Courthouse Medical Centre and Ton-Y-Felin Surgery, while Penyrheol patients will be able to access healthcare at Nantgarw, Abertridwr and Llanbradach surgeries. The article notes that many of these surgeries have been described as "already bursting at the seams".

Procedure for a GP resigning their contract

The ABUHB website provides a link to a documentwith information relating to a GP resigning their contract, which is set out below.

GP practices are independent contractors that are commissioned by the Health Board to provide care through the General Medical Services Contract. GPs can choose to terminate (resign) their contract arrangement with the Health Board. If the practice is a single handed GP, 3 months’ notice is required.

When a practice resigns its contract, it is the Health Board’s responsibility to ensure all patients have access to General Medical Services from the date the contract will end.

The Health Board should follow a process called the Vacant Practice Process, where a panel meets to discuss the options available: The Vacant Practice Panel includes representation from Aneurin Bevan Community Health Council and the Local Medical Committee. Several factors are considered including the size of the practice, existing premises and local population health needs. This process details a number of options that can be considered, examples include:

§ Advertising the practice, with the aim to secure a new GP partnership to take over the practice.

§ Allocating patients to local GP practices - patients will be registered with an alternative GP close to where they live.

§ Health Board Management - the Health Board takes over the responsibility of the practice.

The Health Board should notify patients in writing on how they will access care when the contract ends and should try and ensure that patients still have a choice of a GP practice to register with.

ABUHB notes that there is sufficient money to secure all of the GPs that are needed for the population but there can be issues relating to the shortage of GPs it can attract to work in an area.

2. Welsh Government action

Correspondence from the Minister for Health and Social Services to the Committee on 20 April 2020 reiterates that when an independent GP contractor decides to terminate its contract with a Health Board, that Health Board has a responsibility to ensure the on-going provision of high quality primary care services for those patients affected by the closure. It confirms that ABUHB had issued a letter to patients stating that they would be moved to neighbouring practices and that changes would be in place by 1 May 2020.

The Minister highlights that Wales, along with other parts of the UK, has needed to deal with GP recruitment issues. In 2016, a national campaign was launched to promote medical careers in Wales; “This is Wales: Train, Work, Live”. The campaign supports the recruitment activities undertaken by health boards, trusts and GP practices.

As part of the campaign two incentives have been available. The first incentive of £20,000 is offered to GP trainees who take up a training place in a specified hard to recruit area. The incentive is paid if the GP trainee commits to remain in a targeted area for one year of practice after qualification. A second incentive, available to all GP trainees, is a one off payment of £2,000 to cover the final GP trainee examination costs.

The Minister goes on to say that the campaign, along with the financial incentives are helping to increase the number of doctors choosing Wales to complete their GP training.

Every effort is made to ensure that the information contained in this briefing is correct at the time of publication. Readers should be aware that these briefings are not necessarily updated or otherwise amended to reflect subsequent changes.