Agenda item

Representatives from the North East and North Cumbria Integrated Care Board (NENC ICB) will be in attendance to provide an update on the Foundations contract.

E Joyeaux, representative from the North East and North Cumbria Integrated Care Board (NENC ICB), provided Members with an update regarding the Foundations Harris Street GP Practice contract; the following points were made:

• This update was provided from the perspective of the NENC ICB; unfortunately, practice partners were unavailable to attend today’s meeting.
• Reference was made to the stakeholder letter circulated with the agenda.
• As per the terms and conditions of the primary care contract, notice could be served at any time with standard six months’ notice.
• 1,756 patients would be affected by the closure, which had been a very difficult decision to make.  The reasons for the decision could not be disclosed by the representative.
• Usually, GP practices had in the region of 7,000 patients registered in order to make the practice financially viable.  This was therefore a very small practice.
• The majority of the patients registered were non-English speaking and therefore, as a vulnerable cohort, each would be allocated an alternative practice and have registration completed on their behalf.  This would help ensure that gaps in service provision were avoided as far as possible.  Patients would be contacted via letter again by the end of February 2023 with details of the practice they had been registered to.  The alternative practice would be the closest to their home address.
• In acknowledging the current difficulties being experienced by GP practices across Middlesbrough, it was explained that work was being undertaken to support affected practices in coping with the additional pressure of potentially taking on an extra 200 patients.  Financial resource would be provided to, for example, employ additional reception staff.
• The information had been conveyed to patients in seven different languages via letters, text message and posters, the latter of which had been displayed at such venues as the International Centre and Citizen’s Advice Bureau.

During the discussion that followed, Members raised several points with the representative; the following information was provided in response:

• In terms of the number of affected patients that were asylum seekers, and the measures put in place to ensure access to translators during the 12-month transition period, it was explained that, nationally, the NHS had contracted Language Empire to supply interpretation services.  All GP practices had access to these services.
• Regarding the services that would be lost following amalgamation, and the replication of these, it was explained that the services being lost were standard General Medical Services (GMSs) for primary medical care; Harris Street had become a ‘specialist’ enhanced service for asylum seekers.  The service was separate from the core, but would be rolled out and linked back to migrant health services.  Reference was made to GP practices being independent businesses, and the different operating methods that they utilised, for example: some triaged, some offered specific times for appointments, and some offered online consultations.  The support package being offered would be in the form of a one-off payment for practices to assist with the transition.  Work would be undertaken with partners, such as the Strategic Cohesion and Migration Team, to ensure that new asylum seekers had opportunity to enroll.  Proposals regarding the enhanced service would be submitted to the ICB Governance Board in due course.
• It was confirmed that the ICB had not been made aware of the intended closure prior to the official notice being received.
• In terms of monitoring the successful transition to other providers, this would be carried out and performance reported back to the Health Scrutiny Panel in the autumn.  It was commented that, theoretically, no patient would drop off the system as, owing to classification as a vulnerable group, all would be physically registered.  A Member queried how patients could find out which practice they were registered to if, for example, they moved home.  In response, it was explained that Healthwatch could usually signpost to practices; the NHS contact centre could assist with registration.  If patients were removed from one register due to a house move, for example, they would automatically be registered elsewhere and their records transferred, therefore there would be no gap in care.
• It was explained that, owing to the patient list size and a subsequent lack of viability, there had not been any interest from other GPs.  Different contracting options had also been looked at prior to the termination of the contract, but again, this had not been a viable option for providers.

The Chair thanked the representative for the information presented.

NOTED