Our MP Edward Timpson has been following progress on the fight to save Sandiway Surgery and has been very helpful in keeping up correspondence with the NHS regulatory bodies to ensure that our case is being heard.
He recently wrote to NHS England North West on our behalf. His letter and the reply from the NHS are shown below:
To the Director of Primary Care and Public Health NHS England and NHS Improvement – North West
I have been working for some time now with my constituents regarding the planned closure of a GP surgery in Sandiway, Cheshire. This surgery currently serves over 3700 patients in a rural location and is one of three owned and managed by Danebridge Medical Practice based in the nearest town, Northwich, serving 25000 patients in total.
Danebridge Practice has told its patients that it intends to close the rural surgery at Sandiway and that all GP services will be provided by the remaining two surgeries at Danebridge and Kingsmead located within I mile of each other, but both approximately 5 miles away from the Sandiway population.
Sandiway surgery is in the Cuddington Key Service Centre serving a village population of 5500 and has existed there since 1928. The number of patients registered at that surgery over 70 and under 16 is in total 1421, 38% of the practice list for that surgery. This cohort of the patient list is very dependent on public transport and Cuddington and Sandiway suffer from the very common rural problem of poor public transport links, which make the use of public transport for GP appointments extremely difficult and in the case of Kingsmead surgery, impossible.
The practice has made it very clear to patient representatives and recently to the Cheshire CCG-PCC that they are not prepared to consider keeping the surgery open, despite the fact that the vast majority of patients in the village, and the majority of patients in the practice, do not wish to see the surgery closed.
Danebridge Medical Practice has cited a number of challenges around workforce, finances, sustainability and quality of services, and clearly needs support if it is to continue to manage the Sandiway surgery. They have, in discussions with the CCG-PCC committee, declared that they are expecting partners to retire, but they have a very low expectation of finding replacement partners. This “last partner standing” is a common issue and one that NHS England will be aware of and, I understand, is prepared to help with.
I understand that CCGs around the country are encouraging all GP practices to become part of local Primary Care Networks (PCNs), based around a GP registered list of approximately 30,000 – 50,000 patients, encompassing general practice and other partners in community and social care.
I believe that Danebridge ought to be encouraged to engage with NHS England and the CCG to consider the option of partnering with other practices, to form a PCN which could service the rural community and maintain a presence in this Key Service Centre. This would enable the provision of the service envisaged in the NHS Primary Care Home initiative where “ Staff come together as a complete care community – drawn from GP surgeries, community, mental health and acute trusts, social care and the voluntary sector – to focus on local population needs and provide care closer to patients’ homes.“
I am writing to the Cheshire CCG and to Danebridge Medical Practice, but I believe that in addition, this will require an intervention by NHS England to prevent a short-term issue undermining the strategic intent of NHS England care policies.
Edward Timpson CBE MP
and the reply from Anthony Leo, Director of Primary Care and Public Health, NHS England and NHS Improvement – North West
Thank you for your email dated 16 December 2020, in which you outlined your concerns regarding the future of Sandiway Surgery, which is a branch surgery to Danebridge Medical Practice, Northwich.
NHS England and NHS Improvement are aware of the Danebridge Medical Practice application to close the branch surgery at Sandiway and recognise that this is an important issue for the residents and patients of the Sandiway area.
As you may know, NHS Cheshire CCG holds delegated commissioning responsibility for primary medical services and, therefore, retains oversight and management of local general practice services. This means that decisions are taken locally by the CCG and managed in accordance with relevant national policy and guidance including the requirement for patient and stakeholder engagement.
In relation to this matter, we understand that a decision has not been taken by the CCG at this time and that the CCG’s Primary Care Commissioning Committee has requested further information from Danebridge Practice and had asked it to undertake further patient engagement which the practice has committed to do. As part of engaging with stakeholders, I am also aware that the CCG has been in contact with the Chester West and Chester Health and Overview Scrutiny Committee to keep it updated.
In light of the on-going need during the Covid-19 pandemic to focus on the delivery of patient services as well as the Covid vaccination programme, I have been advised by the CCG that the process has been paused. However, the CCG is committed to ensuring that meaningful patient and stakeholder engagement takes place in due course so that all information and feedback is properly and carefully considered before any conclusion is reached. The CCG has undertaken to keep you updated on progress.
During the course of the last 18 months, all general practices across England have been encouraged to become part of local Primary Care Networks and across the North West there has been extremely high take up. NHSEI in the North West has worked closely with all CCGs to support the development of PCNs in Cheshire and Merseyside, and I am able to confirm that Danebridge Medical Practice (including the branch surgeries) has been an active member of the Northwich Primary Care Network since 2018, supporting a patient population of over 73,000 across all seven member practices, and prior to this date had operated within a local Care Community formation. As part of this, we encourage all PCNs to continue to work closely with all partners to ensure patient access to the range of services for the local population.
Primary Care Networks have demonstrated their real value in the response to the COVID-19 pandemic, including through the delivery of support to care homes and through the resilience they have offered to practices with particular challenges. Primary Care Networks will continue to play a critical role in the NHS recovery from the pandemic, including tackling the health inequalities within our society which COVID-19 has vividly highlighted. PCN member practices, together with their health and care and voluntary sector partners, will collectively deliver the range of services to meet local population needs.
I trust that this response provides assurance that the CCG continues to review matters and will provide you with further updates on progress.
Anthony Leo Director of Primary Care and Public Health NHS England and NHS Improvement – North West