LETTER: Catastrophic deterioration of medical practice
We write as concerned and distressed patients at the catastrophic deterioration in the operation of the Pendle Valley practice in Nelson.
We have been patients of the practice for many years and we have seen dramatic changes. We can remember when the practice was in the doldrums in the early 2000s, providing mediocre care with disinterested locum doctors and nurses.
We can remember the enormous changes that occurred with the engagement of an enthusiastic PCT manager and a clinical lead doctor with a commitment to make the practice and other practices operated by East Lancashire PCT efficient and effective.
During that recent five-year period, every measurable parameter has improved. Permanent doctors were engaged and the quality of care improved enormously. The nurses became more involved and provided more support for those of us with chronic diseases. The appointments system changed for the better and we were able to get convenient appointments much more quickly.
We were also able to see a doctor of our choice who knew our case history; this saved a lot of time, especially when you only had a 10-minute appointment.
Most of all, though, the staff worked as a team, morale was high and the whole organisation radiated kindness and caring. We felt we were receiving the highest quality of treatment and the staff was concerned about us. The clinical lead GP was usually at the practice at 6-30 a.m. and often there until 7 p.m. or later. He, and all the other staff, worked to try to make things better.
A change in Government policy in 2009 resulted in the staff of the PCT-owned practices making a bid to become a social enterprise. The amount of work put into the project was huge. The PCT approved the scheme in 2010 and, at the PCT board meeting where it was approved unanimously, many of the board members emphasised their delight at the approval and acknowledged the work and commitment of all the staff. The staff morale was very high as everything was put into place for the transfer. The staff had even chosen their new uniforms.
Suddenly, three weeks before it was due to launch, the PCT withdrew its approval of the social enterprise. Consultants were appointed at considerable cost to “improve” the business plan to ensure approval of the enterprise. A new PCT manager was appointed, according to the staff, to “sort out the problems” at the practice.
The result of this enormous expenditure is plain for all to see. Despite what we understand to be six-figure payments, the business plan changed hardly at all and the PCT announced to a disappointed and anxious staff in August the social enterprise would not proceed. Instead the practice, along with other PCT practices, would go out to the market to be tendered. Why was all this money spent when it could have been used in other ways? Once again, patients are last on the list to benefit.
The budget to be allocated to the private company which is successful in acquiring the practices will be about one million pounds a year less than that agreed with the social enterprise. Many of the staff now fear they will be made redundant. Meanwhile, staff say the PCT manager is upsetting everyone and has disrupted the previously-effective appointment system, replacing it with a ridiculous one.
It is now almost impossible for patients, particularly more elderly patients, to make appointments at a time of their choosing, if they can ever get through on the telephone. One patient who was really ill was on the telephone one morning and could not get through. At lunchtime his wife managed to get him down to the surgery; when he approached staff he was told t they were short-staffed, but if he would like to wait he could see a doctor. One hour later this was achieved. He was a vulnerable patient.
Going into the surgery, we now find ourselves greeted by glum faces and all the friendliness and camaraderie has gone. Staff, including the clinical lead GP and Michael, the former practice manager, have left and other staff are resigning. Many more are looking for new jobs. The whole thing is catastrophic; being able to see the same GP is now no longer an option and a superb practice has been progressively run down.
Perhaps the PCT can explain why the staff and most of all, patients, seem to have been so shabbily treated, why everyone seems to want to leave and why the service has been made so much worse by what appears to be an interfering PCT manager.