Primary Care Changes in Gloucester

The biggest thing we all have in common, in any community, is our dependence on our GP surgery and all our NHS services. Different issues, at different times: but the same organisations to help us. I have constituents all over Gloucester who, like me, have four generations of the same family who benefit from GPs and NHS Gloucestershire services.

So it’s no surprise that year after year the single largest source of enquiries and complaints I, or most MPs, get is on health issues.

Given the level of interest in health, some key facts about our GP surgeries are not always well known. For example:

  • GPs are not NHS staff, but employees or partners of an independent business (their surgery)
  • Surgeries are paid, by the NHS, a fixed sum per registered constituent that is based on seeing each of us twice a year: other services (including e.g. pharmacies) can also be applied for and contracted
  • New surgeries are usually financed by the GPs partnership, based on the number of patients to be registered and additional services contracted and in close partnership with the GCCG (see below)
  • The Eastgate Access Centre, for example, has just had its contract renewed to provide services from 0800-2000 every day and every weekend to all constituents in our city (and for residents across the county) as well as having a list of registered residents. (Ring 336290 at 0800 sharp and you can almost always get an appointment the same day).

The model of GPs surgeries has changed over time. Increasingly the old model of two GPs in a bungalow is not very practical. Both scientific and medical advances and more complex medical needs mean there are advantages in having two or more surgeries in the same larger building, with more services, like a mini operating theatre: and they sometimes look more like a smaller hospital than a surgery of old. The term ‘Health Centre’ is often more appropriate than ‘surgery’. Where possible these super surgeries also have far more parking too.

Our Gloucestershire Clinical Commissioners Group (GCCG) makes decisions about what our present and future Primary Care should be, based on national guidelines and local circumstances. They’re run by doctors backed by NHS professionals with much experience. MPs have an important role in looking after the interests of our constituents, and working with different partners to make things happen – I chaired a series of meetings with all the bodies involved in the new Kingsway Health Centre, helping to nudge things forward. And local councillors and Patient Participation Groups are also key local stakeholders in making sure, as far as possible, that new or expanded surgeries and wider improvements to Primary Care meet what we need across the city.

Over the last few years there have been a number of changes to our surgeries and I want to summarise some of the most important. It’s worth noting there’s no single model for the structure of new Primary Care surgeries: sometimes a single GP surgery can be expanded, or merged with another/others, or brought together in the same building but still separately structured. Flexibility to the solution is key:

  • Merging 3 surgeries in the giant new Aspen Centre (opened in 2014) in Horton Road, with additional services (including now a new eye surgery that I opened recently) and much greater capacity
  • Expanding the existing Hadwen surgery in Abbeydale with a new 3 storey block (opened in April 2018)
  • Closing Dr Helen Miller’s surgery in College Yard (circa 2019) and merging her Highnam surgery with the Cheltenham Road surgery
  • Doubling the capacity and relocating both the Rikenel surgery and the Eastgate St Access Centre to a new City Centre (ex Quayside) Health Centre with capacity for 18,000 constituents (to be opened early 2020), and additional services like mental health and physio
  • Creating a new Rosebank Kingsway Health Centre, with capacity for circa 30,000 constituents (to be opened in late 2018), which will also relieve pressure on the 2 existing Quedgeley surgeries
  • Searching for a new and larger site for both the surgeries in Hucclecote and Brockworth to relocate to (dates will depend on when the site is identified and secured): they will continue as separate entities under the same roof, sharing access to some services

It’s not all about new and modern premises, close to public transport, or even more space and a greater range of services. Part of the reforms necessary to make sure my constituents can be seen more quickly include new ways for surgeries to work together. So all 76 GP surgeries in our county are now in 16 clusters, based on different patient needs, and working with all three of the NHS Trusts. For example, our inner city cluster is working much more closely with Mental Health (2gether) Trust. Altogether it’s intended that the cluster way of working and Improved Access will result in approximately 40,000 more surgery appointments a year than now, with appointments up to 8pm on weekdays and on Saturday mornings.

Of course all this can only work if doctors want to be and stay as GPs in our city and county. So there is another scheme (‘Be a GP in Gloucestershire’) which is designed to attract and keep GPs working in Gloucestershire, and early results are encouraging.

I believe the changes made over the last few years are taking Primary Care provision in Gloucester and Gloucestershire to a new and better place. It would be wrong to say there aren’t challenges: there are still backlogs of patients in some surgeries, patients going to A&E for the wrong reasons and not enough people who know about the Access Centre and its evening and weekend accessibility. As a society we aren’t using all the advantages of home technology to solve simple issues enough and mental health issues seem to rise inexorably.

But I am grateful for the work done by the GCCG and surgeries in planning ahead to see how and where we can provide good Primary Care for the needs of the future as well as today, and of course to the doctors, nurses and many others who work hard in our surgeries to provide the healthcare that those of us who’ve lived abroad will never take for granted. I believe overall that things are getting better, and the opening of first the Kingsway and then the City Centre Centres are important parts of the journey.

That’s always a risky thing to say, so please do email me with your criticisms, comments and reactions via richard.graham.mp@parliament.uk!

Best regards

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