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Hebden Bridge Group Practice

From Gwen Goddard

Saturday, 25 August 2018

I was disappointed this week to see the following notice in the window of the Valley Road surgery.

From 30th August 2018 due to demand there will no longer be a telephone duty doctor system for urgent appointments. In its place there will be from Monday to Friday 8 am until 10.30 am a walk in surgery at Grange Dene Medical Centre where patients with a single urgent problem can sit and wait to see an appropriate clinician. Where the patient has a problem which is not urgent the Practice will be providing more routine appointments.

What does one do after 10.30?  Put more pressure on A&E I suppose.

No way do I want to criticise or complain about our hardworking and respected GPs.  

What I would like to know is what consultation took place about the removal of this much valued service.  I looked on the Practice's website for more information but found it to be unhelpful in this respect and out of date in several ways. 

We all know the NHS is in dire need of proper funding and there is a shortage of GPs and other clinicians  -  over the last twelve months four of our doctors (all female) have left or will shortly do so  -  but the loss of the telephone duty doctor system locally is very unfortunate.     

From Richard Peters

Sunday, 26 August 2018

Our surgery doesn't do consultation.

This is another arbitrary decision that you only find out when you happen to visit the surgery (previous changes to emergency issues, repeat prescriptions).

Never mind they could easily send us all a text about changes like this - maybe too much trouble.

The doctors will have had little to do with this decision. It is the Practice Manager who seems to treat patients with disdain. The patients committee? Many have tried and given up. Our surgery is in effect a private monopoly, so knowing we have nowhere to go, why should they bother to treat us like 'customers'

From Kez Armitage

Sunday, 26 August 2018

"The Practice anticipates that this change in the service will continue to ensure that we are able to provide the speediest access to those in greatest need." 

Right. So a visit to Mytholmroyd with its ongoing road works, sitting and waiting (as the response to Hebweb says) is going to provide speedier access to healthcare advice than a one or two minute call to your own home from a duty doctor? 

The current system of telephone consultations works well and is highly valued. Is there any evidence it's not used? Or it it simply too popular? And were the opinions of users solicited? And, most importantly, is there anything that we can do to reverse this decision?

From Mark H

Monday, 27 August 2018

What decision making process determined that the walk in service should be 0800-1030 in Mytholmroyd?

Spare capacity on buses or trains?

No, they're already full of folks going to work or to learn. It's Rush Hour.


Luckily there's only 16 months until the flood works are due to finish. 16 months while the entrance to - and exit from - Grange Dene is at the epicentre of the traffic maelstrom. Always good to add a significant number of cars containing sick people and stressed drivers... 


Who asked the people working at Grange Dene about real problems or family issues around having to get there in time to start work at 0800?

If it must be done, please consider opening the sessions 1000-1230.


From Arla R

Friday, 31 August 2018

As a vulnerable adult who has mental health crises from time to time, and has been turned away by the Community Mental Health Team following GP referrals several times in the last four years, the loss of this service will impact me hard.

How do they justify cutting a service they were finding difficult to manage "because too many people needed it"? Surely that's where they need to put more resources?!

However, I would also say that last time I used this service, which must have been only a week or so before it was stopped, I wasn't able to get through on the phone for more than half an hour after the practice lunch break. I was unable to cope with trying to get through on the phone again, and it was only because someone else was able to phone on my behalf that I was able to get a call back and then be seen face to face later in the day.  

So it's justifiable to say the service wasn't working very well - but not to scrap it.

I wonder if there is any way Upper Valley residents can find a way to make the GP practice listen to patient need?  Certainly, in a mental health crisis the last thing you want to be doing is forcing vulnerable, unwell people to find a way to get to Calderdale Royal A&E and then somehow cope with hours of waiting time, especially in school holidays when A&E is full of parents and children. When all you maybe need is some meds to see you through a few days - as long as you don't have all those added stresses.

From Zilla Brown

Friday, 31 August 2018

As someone who has a long term, indeed life long illness that can have serious exacerbations from time to time  I have always  depended on being able to get advice on any  new medication needed , and an emergency prescription, or seeing the doctor on the same day in an emergency.

What are people like myself supposed to do now if we need an urgent appointment? Do the Practice expect people who are bed ridden or too ill to leave the house to totter off to Mytholmroyd? Are they really implying that we must go to A and E in Halifax (however long that lasts) as a last resort?

I'm not aware of any alternative arrangements being offered and think the practice could have handled this better.They are supposed to offer primary care, what services are they offering now except passive ones like blood tests and appointments that you have to wait 3 weeks for? Even after being asked by letter to ring the practice  I was told I had to wait 3 weeks to speak to a doctor. What can be done? Write a letter?

From Eileen Cann

Thursday, 6 September 2018

 I acknowledge Richard Peters' point that patients have given up on the Patient Reference Group but it seems to be one of the only ways to get the patient's view across. The HBGP website states: "The aim of the Patient Reference Group is to work towards improving and developing patient services. This group of patients help voice the views, needs and requirements of our Practice Patients The group helps influence a positive change in the services provided by Hebden Bridge Group Practice. The Reference Group comprises of the group members, Practice Business Manager and other health professionals." 

I have emailed this group - prg.hbgp@gmail.com - to ask them to:

  1. Let me know what the consultation process has been prior to adopting the new system
  2. How I can attend a meeting of the PRG where the new system will be discussed with the Practice Manager. I understand meetings are open to all patients.
  3. Let me know the most effective way to register an objection to the way this decision has been made and implemented.

Can I suggest that if you object to the continuing deterioration of the service we patients receive from our local GP practice, especially this latest one, that you email the PRG and send a hard copy of your email to the Practice Business Manager - who does not publicise his email. There must be a way of letting our views be heard and getting some accountability from the management of the HBGP.

From Gwen Goddard

Friday, 7 September 2018

I have emailed the Patient Reference Group asking if their meetings are open to all patients and, if so, the date, time and venue for the next meeting.  I will post the reply here.

From Mal Campbell

Thursday, 13 September 2018

I went in for an appointment today. No-one in the waiting rooms when I went in, no one in the waiting rooms as I left. What is going on?

From Jae Evans

Sunday, 16 September 2018

I wish to add my concern at the removal of GP telephone 'call backs.'  As an adult, M.E (Chronic Fatigue) sufferer, I can be house-bound for days, sometimes weeks with pain and fatigue.

Suffice to say, that telephone 'call-backs' were perfect for me: 2 or 3 minutes to allay my fear of a new pain or to moderate a prescription. 

The sudden removal of this policy is shocking.  As when I am poorly, I simply am not able to get to the surgery, let alone have the energy to sit and wait until a GP could see me - then to get home.  

This is aside from the absurd time slot given to the new 'sit and wait' policy: Who - thought early morning rush hour would be a great time?  The appalling road and traffic situation is completely overwhelming for a vulnerable person - such as I am when poorly.

Presently, I have a question regarding a serious issue that I hope my GP can answer: I have just made an appointment - 4 weeks to see him.

I hope I don't die waiting!  

From Lisa M

Monday, 17 September 2018

I’d like to join you all in saying how cruel and impractical this change is. 

Surely we have some sway as patients. 

As someone with two chronic life long illnesses and one other long term condition I need to be able to get help at short notice for advice and prescription queries.

How can changes this severe but made without consultation? They must change this back. It was hard enough getting help as things were.

From Jenny Shepherd

Tuesday, 18 September 2018

Calderdale & Kirklees 999 Call for the NHS asked the Practice Manager Tony Martin what exactly is going on with changes to urgent appointments. 

He told us that routine and urgent home visits for patients who can't get to the Mytholmroyd walk in, and phone calls for patients with treatment plans, are still available through Hebden Bridge Group Practice's new urgent care system. 

More info here 

From Gwen Goddard

Friday, 21 September 2018

Tony Martin, the Practice Manager, told me yesterday that the Patient Reference Group met the previous day 18th September. He did not say when it would meet again.

The link given in Jenny Shepherd's recent post on this subject gives a lot of interesting information and I recommend its reading.

From David H

Friday, 21 September 2018

Very strange! Gwen Goddard asked on 7 Sept when the next meeting was to be held. They replied on 19 Sept to say that it had happened on the 18 Sept and not giving a date for any future meetings. What gives the impression that outsiders (aka patients) are not welcome? Or perhaps l’m being totally unfair . . . 

From Graham Barker

Friday, 21 September 2018

Thanks to the link supplied by Jenny, I’ve read practice manager Tony Martin’s comments about GP shortages and in that context the new scheme starts to sound very much like an act of desperation. I’m guessing that the deliberate aim is to cut demand to suit supply in a situation where the practice can’t increase supply.

One might be able to sympathise if all the facts were more out in the open, but it’s difficult to trust a practice that seems to prefer evasive spin to honesty.

From Michael Prior

Monday, 24 September 2018

One factor in all this is the status of the Valley Medical Practice which is that of a private-sector company/partnership (the exact status of the Practice is unclear) which has a licensed local monopoly to provide medical services under a contract with the NHS from which it makes profit. 

What is unclear is exactly what level of service it is contractually required to provide and whether the per capita fee which it gets from the NHS varies as this level changes.

Rude questions like this hardly seemed necessary in the 'good old days' of the family doctor on call 24-hours a day but they it are relevant to the current problems with the Valley Medical Practice. When a GP leaves the practice and its wage bill consequently falls as does its service provision, does its per capita fee also drop. Just what services does its (confidential) contract with the NHS require it to provide?

Companies like Virgin Care are not interested in moving into local practice out of the goodness of Richard Branson's heart but because there are good profits to be made out of GP-led health provision.

Sorry, but the Practice Manager's pleas are not convincing. If you want more employee-doctors try paying them more and taking less profit from whatever corporate body lies behind the Practice.

From Jay Jones

Monday, 24 September 2018

The Practice Manager's comment, “The Practice cannot be responsible for any transport arrangements our patients may have or choose to make." indicates either the lack of understanding or simple unconcern for the impact the new arrangement is likely to have.

From Sue S

Monday, 24 September 2018

 In response to the comments about the practice as a private business, contributors need to understand that all GP practices are contracted businesses to the NHS. The terms of the contract vary slightly each year but there is a consistent and clearly understood core GP contract.  It's publically available here.

GP's are also able to choose whether they wish to provide other services for which they are paid additional fees. Most of these are within the realm of Public Health need, such as vaccination programmes, and others are in order to provide services nearer to the patient (to save attending acute hospital care) and include joint injections and some medications for example.

There is a perception that GP's are paid a fortune and they are not. They are paid a few hundred pounds a year per patient. From this they need to cover, all staff costs, building related costs, insurances, rent/rates etc etc. as do all businesses. Once these are deducted, there is not a lot of 'profit'.

The decisions made will not be about cost, but about a national shortage of GP's which is hitting everywhere including Hebden Bridge. 

Patients (I am one too) do need to start to understand that the NHS, although free at the point of delivery etc, just cannot continue to be used as it has been in the past. There is a tipping point at which it will no longer cope with the increasing demand and (yes I will say it), misuse by some, and it seems that HBGP has finally caught up with the picture in large parts of the country already. 

Finally - I am - as you might have guessed - a PM in a GP Practice elsewhere. This decision will not have been taken in isolation - the GP partners would have made the final decision, not Mr Martin the PM.

Why not give the open access a try and see if it works for you when you have an acute need. I work in Manchester and used the telephone service. I will of course miss this, wonderful service. I will now need to leave work 2 hours early in order to attend an appointment - or take a day off even. However if everyone gets used to seeing other, very capable professionals, instead of automatically seeing a GP, it is likely that another review will take place and we might see the service change again.

To influence this you can join the PRG online, or call in and ask to join - you can then make your voice heard.

From Michael Prior

Monday, 24 September 2018

Susan S does really answer my question: when a GP leaves and the practice wages bill drops, is the annual fee claimed by the practice reduced? Or is it in the best financial interests of those who own the practice to reduce service provision whilst claiming the same per capita fee? To put it bluntly, when Valley Medical stopped taking emergency telephone calls did it continue to claim the same per capita fees? Just asking.

From Janet Moore

Tuesday, 25 September 2018

I am thankful that I have only had to see a doctor about simple, routine problems.  However, I know several people who have had serious, complex conditions.  I know women who have gone through pregnancy and childbirth, and I know 3 families who have had relatives die of long term illness.  The care and attention they received from doctors and nursing practioners, as well as reception and office staff is exemplary. 

Doctors going out of their way not only to deliver the very best medical care, but also to spend time they really did not have, to explain matters carefully and gently.  Time to be with patients and their relatives as they came to terms with devastating information.  Time to check and double check results and hospital arrangements.  Time to just sit as someone took their last breath. Doctors depriving their own families of time as they carried on working long after the scheduled shift had ended.

I do not envy anyone the job of trying to organise a medical centre, so many people, so many needs, so little money.  I believe this practise is trying to deliver the very best care to every patient in their area, and I just want to take this opportunity to say thank you.  Because I know that regardless of where this re-organisation may have reached, if I or those I care about, suddenly had need of a doctor, they would respond immediately and effectively.

From Michael Prior

Tuesday, 25 September 2018

Sorry to post again but Susan S inspired me to look at the general GP contract via the link she provided. It is actually rather opaque on the precise level of fees charged for what but it does have a very clear statement about the Patient Participation Group about which there has been some discussion here. It read:

Patient Participation
5.2.1. The Contractor must establish and maintain a group known as a “Patient Participation Group” comprising some of its registered patients for the purposes of:
(a) obtaining the views of patients who have attended the Contractor's practice about the services delivered by the Contractor; and
(b) enabling the Contractor to obtain feedback from its registered patients about those services.
5.2.2. The Contractor is not required to establish a Patient Participation Group if such a group has already been established by the Contractor in accordance with any directions about enhanced services which were given by the Secretary of State under section 98A of the 2006 Act before 1st April 2015.
5.2.3. The Contractor must make reasonable efforts during each financial year to review the membership of its Patient Participation Group in order to ensure that the Group is representative of its registered patients.
5.2.4. The Contractor must:
(a) engage with its Patient Participation Group, at such frequent intervals throughout each financial year as the Contractor must agree with that Group, with a view to obtaining feedback from the Contractor's registered patients, in an appropriate and accessible manner which is designed to encourage patient participation, about the services delivered by the Contractor; and
5.2.5 review any feedback received about the services delivered by the Contractor, whether by virtue of clause 5.2.4(a) or otherwise, with its Patient Participation Group with a view to agreeing with that Group the improvements (if any) which are to be made to those services.
5.2.6 The Contractor must make reasonable efforts to implement such improvements to the services delivered by the Contractor as are agreed between the Contractor and its Patient Participation Group.

I drew particular attention to 5.2.3 and 5,2,6

Current GP contract

See also

HebWeb News: Hebden Bridge Group Practice changes appointments system (25 Aug)