Final

Engagement

Report

Regarding the proposed merger of:

and

December 2019

Produced by Nikki Ibbotson – Project Manager

CONTENTS

Background & demographics

Page 3

Why are we writing this report?

Page 4

Why are we planning to merge our practices?

Page 4

Engagement process

Page 5

Feedback

Page 6

· Feedback about Practices

Page 7

· Feedback about Merger Plans

Page 9

· Concerns about Merger Plans

Page 10

· Suggested improvements

Page 11

What next?

Page 7

Key themes & recommendations

Page 8

Appendix 1 – How we engaged with the public

Page 14

Appendix 2 – Letter to Households

Page 16

Appendix 3 – Community Stakeholders contacted

Page 18

Appendix 4 – Letter to Community group/leader

Page 19

Appendix 5 - Stakeholder Briefing Note

Page 21

Appendix 6 – Example of engagement with PPGs

Page 23

Appendix 7 – Frequently Asked Questions

Page 26

Appendix 8 – Engagement Information Poster

Page 29

Appendix 9 – Press releases

Page 30

Appendix 10 – Feedback detail – drop-in events

Page 34

Appendix 11 – Feedback detail – Survey results

Page 36

Appendix 12 – Equality Monitoring Information (survey)

Page 42

Alternative formats for this report

Page 48

1. Background and demographics

Allerton Medical Centre provides primary care services for around 6000 people in the Chapel Allerton area (in a converted house with extension and portakabin on Montreal Avenue). Westfield Medical Centre provides primary care services for around 4300 people in the neighbouring Chapeltown area (in leased premises within a large health centre hosting other community services on Chapeltown Road).

The demographics of the two Practices can be seen below:

Allerton Medical Centre

Westfield Medical Centre

2. Why are we writing this report?

In July 2019, Allerton and Westfield Medical Centres applied to the NHS Leeds Clinical Commissioning Group (CCG) to join together to become a larger practice. This is called a ‘merger’.

It is important to understand that this proposed merger does not involve any patients needing to change GP Practice. Patients will remain registered and will still be able to see the same Clinicians (Doctors, Nurses, Healthcare Assistants, Midwives etc) and Patient Support Staff in the same building as they do now. Both locations will remain open, patients can use the same numbers to call us and no staff will be made redundant. Opening times will remain the same and extended hours appointments will be available to all patients. All clinics and support services available to both practices will remain unchanged. Patients will be able to get their medications in the same way they do now and can be seen on the same day if they are really unwell. The merger just joins things together “behind the scenes” giving us larger patient and staff bases to help us deal with some of the challenges we face in primary care.

Although there are some differences between the two patient populations to be merged we believe that any changes as a result of the merger will affect all registered patients in the same ways, regardless of any protected characteristics (such as gender, age, disability and sexual orientation).

We have a responsibility to involve our patients when we make changes to our practices and so we carried out a month long engagement with local people. The engagement aimed to:

· Inform our patients about the proposed merger

· Understand people’s views about the merger

· Understand people’s general views about our practices

The report outlines what people told us and how we will respond to their feedback.

3. Why are we planning to merge our practices?

The NHS Long Term Plan sets out how we think we can overcome the challenges that the NHS faces, such as staff shortages and growing demand for services. One of the ways we can do this is by ‘doing things differently’. This means looking at how local services can work in partnership to meet the needs of local communities. You can read the Long Term Plan here: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/the-nhs-long-term-plan-summary.pdf

We need to do things differently in Chapeltown and Chapel Allerton to ensure that our GP services are sustainable in the future. Representatives from our practices are currently in discussions about merging. We think that by working more closely together we will be able to better meet increasing demand and provide a wider range of services to people registered at our practices. We believe merging Practices will put us in a better position to invest in our staff and their continued development as well as our facilities and equipment.

However, it is of utmost importance to both of our Practices that we maintain the more “personal” approach to primary care that is so important to our Doctors, Staff and Patients. We want to streamline things behind the scenes but keep the community spirit and continuity of care. Effectively we want to run the back-office parts of the Practices like efficient superstores but the patient-facing parts like friendly corner shops!

Patients will see very little difference following the merger. However, it is hoped that the merger will provide a number of benefits to registered patients:

· They are more likely to have continuity of care with a regular GP

· There will be more appointments available with a range of clinicians, not just GPs

· Patients can choose to access services/clinics at either site

· Staff can share knowledge and best practice, improving patient care

· There will be more GP and Nurse appointments as their administration will be shared

4. Engagement process

We have a responsibility to involve (engage) our patients when we make changes to our services. It is important that we understand the needs of local people and plan our engagement in a way that gives all our different communities an opportunity to have their say.

This engagement aimed to:

· Inform our patients about the proposed merger and reassure them that we will continue to provide the same (or improved) quality services

· Inform individuals and organisations in the local community of our plans so they could also offer feedback and support

· Gather patient experience, suggestions, questions and concerns regarding the merger – to understand people’s views and respond to them

· Understand people’s general views about our practices and services

· Reassure everyone that decisions will always reflect on patient concerns/feedback and not be made purely on financial/resource grounds

We worked with both of our Patient Participation Groups (PPGs) to develop our engagement plan and all our engagement documents. The PPG is a group of patients at the practice who meet regularly to support us to involve local people in our work. We had discussions with our PPG members before we sent information out to patients so we were confident it made sense to those using our services. You can see an example of this in Appendix 6 – where PPG members asked questions regarding the Engagement Plan which they signed off before the engagement went live. We also made updates to practice websites based on their feedback.

We know that in our area there are some specific groups that might need more support to get involved in the engagement. We developed an approach to our engagement that ensures that all our communities have an opportunity to share their views. We also wanted to involve other key stakeholders in the engagement, like the voluntary sector, other local practices and local councillors. See Appendix 1 and 3 for details of how we engaged the public.

We promoted the engagement by:

· Sending a letter to every registered household (Appendix 2). The envelope of each letter also specified the information was from their GP Practice and needed to be shared with all patients in the household.

· Sending a letter/email to local community groups, religious groups, local councillors, local support groups and charities etc (See Appendix 3, 4 & 5)

· Sending a letter/email to local GP Practices, Dentists & Pharmacies (Appendix 3 & 5)

· Holding drop-ins on Nov 23rd, 24th and 25th- giving people a chance to speak directly to staff about our proposal

· Posts on social media including Twitter

· Putting up posters in the GP practices and local venues (Appendix 8)

· Sending text messages to patients who have a registered mobile phone

· Adding the engagement to our websites, including our Frequently Asked Questions sheet (Appendix 7)

· Releasing press statements to local press/publications (Appendix 9)

· Inviting patients in documents and conversations to call, email or write with their feedback

We captured people’s views using an online and paper survey (available on both Practice websites and from Reception desks). The survey was setup and results collated by the Clinical Commissioning Group (CCG) to ensure security of patient data. The survey included questions in 3 areas – firstly helping to understand the patients experience of the services provided; secondly to collect feedback on the plans to merge the practices; and thirdly equality monitoring to help us see if we collected views from anyone representing our patients with various ‘protected characteristics’. The survey results can be found in Appendix 11 and 12.

People also shared their views at our drop-in events. We planned these for 3 different times of day on three different days of the week (including weekends and a weekday evening) at 2 different venues (one further north and one further south within the geography of the area and both accessible to patients with mobility issues). This was in order to give as many people as possible the opportunity to come to an event if that was their preferred method of engagement. The Chairs of our Patient Participation Groups also attended two of the drop-in events. We collated information from the drop-in events in the form of questions raised and answers provided (see Appendix 10).

We made our engagement documents available in alternative formats on request and as we knew that language may be a barrier to many understanding our information we worked out which were the next five first languages (after English) in our patient population and added translations to signpost anyone needing further assistance to us. Each of the five translations (Polish, Romanian, Urdu, Punjabi and Arabic) were checked for their accuracy by someone for whom that was their first language and our staff were briefed and ready to assist anyone requiring further translations with the use of Language Line in the Practice.

All patients registered at either Practice to receive text alerts were also sent the following message:

“Exciting news! Today we have announced plans to merge Allerton and Westfield Medical Centres. A letter has been sent to your household and you can find further information and a link to our survey on your practice website in the News section. You can have your say and visit our drop-in events (see letter or website for details). We look forward to hearing your thoughts.”

We obviously also involved the staff from both Practices, asking for their input and feedback regarding the merger plans.

A copy of each of the documents published and the details of how we engaged can be found in the Appendix of this report.

5. Feedback

24 people responded to our survey (online and paper copies) and 10 people attended our drop-in events. We also received feedback in person and during telephone calls to the Practices further to sending information out to households and comments from patients responding to the Friends and Family test text messages. Whilst this may seem a low response rate and is even below the 1% predicted in the planning stage of the project it is worth noting that this merger is categorised as “low impact” and “low risk” and that many patients understood that essentially there would be no change for them and little reason to engage. It is clear from the engagement methodology (Appendix 1) that patients were encouraged to give their feedback via a range of means over an extensive time period to feed into this engagement process if they wanted to.

We had feedback from one patient regarding the survey itself and some missing options in the multiple choice answers. We acted on this immediately and added options for ‘single’ relationship status and ‘self-employed’ employment status missed in error. We also had feedback from stakeholders we contacted thanking us for the information and in some cases even asking why this was the first time they had ever been involved in engagements of this nature.

The feedback from patients attending the drop-in sessions was really positive. We had 4 people attend the first event, 2 the second and 4 the third (6 Allerton patients and 4 Westfield patients in all). They all came to voice concerns and gain a better understanding of the reasoning behind the plans and not only did every single person say they felt assured about the plans by the time they left but some even said they were surprised to find they now emphatically supported and would encourage the plans! One patient commented that it was unfortunate we couldn’t speak face-to-face with all of the patients so they could benefit from the opportunity to better understand how the merger has come about and how it will positively impact on the patients and community.

N.B. Comments in quotation marks in the rest of this section are verbatim from patient feedback.

a. What did people tell us about their experience of using the practices?

Patients told us that they wanted to keep the feeling of small, personal, practices where they were treated as people and not numbers.

In general patients expressed that they were very happy with the practices exactly as they are in terms of the quality of care they receive - with many speaking very highly of the GPs and Nurses. However, we did hear conflicting opinions regarding support staff with comments such as “most of the receptionists recognise the patients (and) are always helpful and friendly” and “as always receptionists are friendly” balanced by others saying: they found their manner “rude”; that they’d like to see “the reception staff have more training and not to sound so miserable”; and “I don’t want to hear the word NO from reception staff, when asking for an appointment. They all need to understand the patients’ point of view and apologise first if there is a problem”. We had some interesting conversations around this point with members of the Patient Participation Groups too and discussed how we could encourage more consistency in the information that support staff provide to patients and the way in which patients and our staff treat each other.

As with most GP practices the main area of dissatisfaction focused on difficulties in getting appointments though, especially with their preferred Clinicians.

Patients indicated that the three things that were most important to them when making an appointment were:

· Getting an appointment quickly

· The quality of care that they receive

· Seeing a specific person at the practice

With regards to getting an appointment quickly patients made comments such as:

· “I have to wait several days to see my doctor, sometimes a week and when one needs help that is not good” (and other patients saying this is more like two or more weeks)

· “I have had to wait over an hour after my appointment time to see a Dr on several occasions and yet when I was less than 5 mins late, due to parking difficulties, I was told I might not be seen”

· “It is very difficult to get an appointment. Phone lines are always busy and if you do get through its difficult to get an appointment. On the last 3 occasions I have been told there are no appointments available. I want to be able to make an appointment.”

· I would like to see “Better and quicker appointment system, not having to wait weeks for a routine appointment with a particular GP”

· I would like to see “more Dr appointments available generally and therefore an increase in appointments without the need to wait”

We are very aware that with increased demand on services over recent years this is the largest area of discontent within our patient populations. This is one of the many reasons why we are considering the merger. Sharing the administration for the two practices means that clinicians will have more time available for appointments and we will be able to look at ways of restructuring our appointments systems to better meet patient demands. This will be an evolving process, as it is now, but we hope the merger will put us in a better position to consider improvements such as “appointments outside of core hours…to support those who find it difficult to make day time appointments” as suggested by one patient and hiring specialist staff we couldn’t afford as smaller practices able to “make out prescriptions without a Dr having to sign” and “do the triage work to release the Drs” as suggested by another.

Patients also raised some issues regarding prescription processing at Westfield. We felt this was something requiring more imminent attention that was unrelated to the remit of the merger so we arranged for the Westfield PPG Chair to meet with the relevant staff at the practice and work on resolving the issues. As a bonus they even produced an infographic to help patients understand lead times on repeat prescriptions which is due to go on websites and up in practices this week! We are planning similar work signposting patients to services as a direct result of the feedback we received in this engagement that some patients were not fully aware of the services they could access in the practice and local community – again with input from our PPGs.

Some patients also explained that accessibility can be an issue for patients will mobility issues and disabilities. For example one patient stated that “Allerton MC is a small building which has its limitations for those patients who have a disability. The merger may help to provide a better service for these people” and another patient who attended a drop-in was reassured that the merger would not impact on her being able to access a wound clinic she currently attends at Westfield for dressing changes that she finds easier to get to due to the lift (as she is currently a registered patient at Allerton). We were pleased to receive feedback from patients with various disabilities in this engagement process as it helps us to shape our services better for groups in our patient population with differing needs.

Patients also commented on the premises themselves and related issues with parking. This complaint is covered more in section C to follow but it’s worth noting that patients from both Practices mentioned it as an area that they struggled with regardless of the merger. Comments included terms such as “limited parking”, “lack of parking” and “parking is an issue with me”. Whilst there is little we can do in this regard (and it is an ongoing issue) we will consider how we spread our appointments in order to help reduce congestion where possible.

b. What did people tell us about the proposed merger?

We asked people to tell us what they liked about the proposed merger plans. We had a mixed response in the survey. It seemed that some patients had completely understood the intentions of the merger and the necessity to make the proposed changes. They made comments such as:

· “I think that, with the NHS and GP practices under increasing pressure, the plans for this merger are very forward thinking and will be a useful and positive development for patients”

· “I can see the benefits in terms of economies of scale. This should lead to efficiency for Drs. It should also lead to the joint practices being able to employ more specialist support staff more easily”

· “Bigger scale will mean flexibility of appointments and a broader range of specialists. Allerton Medical Centre is, in my opinion, too small to function effectively on its own”

· “Improved viability of the practice. Increased range of services. Prospect of access to broader expertise”

· It is “hard to argue with the stated intentions (attract/retain high calibre staff, meet increasing demand, and provide a wider range of services)”

· It would offer “better options for getting an appointment, access to more nurses and doctors, allowing me to choose to see the doctor of my choice”

· “We will be able to access more specific care for certain chronic conditions”

· “A sharing of expertise can be beneficial for both staff and patients”

· “The potential for more availability of appointments will improve”

· There is a “possibility to extend more specialist services and to share knowledge”

Other patients said that whilst they weren’t against the merger they did have reservations or that they were as of yet undecided as to whether they thought it a good idea or not.

Whilst others opposed the plans:

· When asked what they liked about the plans one stated “nothing” and another “unfortunately nothing”

· “I don’t like the idea at all and don’t accept it is to improve services and patient care”

· “Not happy at all…Quality of service will go…please just find some land in Chapel Allerton and build new one”. “(I) will look for another doctor practice if you merge”

· “I will not use the Westfield practice as I hesitate to go on foot through Chapeltown. There is no parking area”

· “I do not think this will improve the service”

· “It is unclear how the merger will actually deliver the stated benefits”

· “I think you need to reconsider the merger”

· “The new surgery is not in a favourable area. There is a lack of parking as well”

It seemed that some of the negative comments were made by patients who had not understood (or didn’t believe) that they would still be able to access the same services at the same location after the merger. Comments in later sections suggested that they had understood there would be a “relocation” or a necessity to visit the other site as opposed to an increase in choice to visit either. Some of the patients who attended the drop-in events made similar comments until they were reassured that neither site was closing and that they would definitely be able to see their usual GP at their usual location if they chose to. Patients’ specific concerns were also noted in section C. It is also worth saying that patients we spoke to perceive an invisible divide between Chapel Allerton and Chapeltown – with different demographics and culture and different reputations. We hope that being able to access services at both sites (if desired) patients will come to see that they are all part of the same community with the same needs.

c. We asked people to tell us if they had any concerns about the merger.

The patients expressed concerns that the personal feel at both practices may be lost. Patients from Allerton who completed the survey made comments such as “I worry that the friendly atmosphere which I have enjoyed at Allerton may be spoilt” and “one bigger practice may lose the ‘personal family’ connection that has been a part of Allerton Medical Centre for the 50 years that I have been a patient”. Patients from Westfield who attended the drop-ins made similar remarks. We reassured them that the ‘small is still beautiful’ approach was an integral part of the ethos and vision shared by Doctors and staff at both practices. It is really important to us that whilst making things more efficient behind the scenes we maintain strong personal service and care.

As mentioned earlier, one of the largest concerns for the patients is the ease with which they can obtain an appointment (and often with a specific person) and therefore their worries regarding the merger concerned how any proposed changes would impact on that. A couple of the comments also cited fears regarding the increase in patient numbers – however, our plans involve the registered patients of the two practices. This number is not set to increase – it is the same two patient lists merged into one list, still using two sites and the same (and additional) staff. We are not anticipating any influx of new patients. Again we hope to alleviate concerns that “waiting times for appointments will become even more disrupted with more patients being involved” and that “it will get too big & have to wait even longer to see the GP you aren’t wanting to see”.

A theme in the feedback at the drop-in events and in survey responses related to why it was Allerton and Westfield proposing to merge rather than other practices in the local area. Whilst some patients had worries that sites would be superseded – such as the patient who said they were concerned that “Allerton Medical Centre, being a smaller and more dated building will close”, a few suggested that finding new premises was actually the answer – “It would be better to find a larger premises with a decent car park, difficult in Chapel Allerton due to cost of lease” and “perhaps both practices could find a new site that is favourable for all patients”. Obviously options like this are always under consideration by Doctors and Managers in primary care, trying to meet patient needs in the best ways possible. We are also very aware that parking at both surgeries is, as one patient put it, “pretty bad” and that patients “don’t want that to get worse if more patients go to one or another surgery”.

At present however, there are no options to build new premises (or patient car parks!) in the locality and merging the two sites into one new building is not a viable prospect or in line with the shared vision of the two practices and their staff. It is this shared ethos and history of strong collaborative working that is also the rationale behind the merger being these specific practices rather than others in the vicinity. Partners at Allerton and Westfield feel they have the same approach to patient care and welcome working more closely together providing patient-centred care in this community. There are no money-making motives in this decision. There are economies of scale in merging some aspects of the practice businesses but this helps us to fund improvements in staffing and services that directly benefit the patients which otherwise we would not be able to afford. So in answer to the patient who asked “Are there unstated financial reasons for the merger?” – our answer is ‘No’ and in answer to the patient who said “I believe that the merger is a cost cutting exercise that will be detrimental to patients” – we hope to convince you otherwise.

d. We asked people what changes/improvements they would like to see as a result of the merger

Whilst the merger itself will involve a lot of changes behind the scenes we expect that patients will see very little obvious change come Spring 2020. That said we are merging the practices to benefit the patients, so we do envisage making improvements to services moving forwards. With that in mind we wanted to understand what the patients would like to see change or improve so that we can try to incorporate as much of this feedback into our planning in the coming months as possible.

One of the most common requests from patients regarded extended opening hours and an “increase in the number of out of normal working day hours appointments”. At present Westfield does not offer extended opening hours and Allerton offers some early morning appointments. We are planning to offer extended hours appointments for patients at both sites from the Spring and we will look at how we can spread appointments to better cater for the needs of the patients.

Patients also suggested “other specialisms to be available which aren’t already covered at our practice” including “coeliac clinic for annual reviews”. One of the main reasons behind merging the practices is the opportunity to have a wider range of staff and services available. We have already recruited an Advanced Nurse Practitioner to work at both sites who can assist with triage and prescribing (exactly as per one patient suggestion) and we are trialling some group clinics where patients from both practices can come together with a GP to discuss their specific condition. We have had one for Diabetes care and have a Coeliac clinic in the pipeline. We are also recruiting GPs and hope to attract new Doctors with a range of specialisms and skill sets.

We have already mentioned that patients would like to see “more availability of appointments with all health professionals” and “obtaining an appointment, particularly urgent appointments, easier”. We will be looking at our appointment system to investigate improvements that can be made to provide more on-the-day and pre-bookable appointments to patients at both sites. From April, at the very least, we promise there will be the same number of appointments available but we hope to offer additional appointments with a range of Clinicians to meet patient needs over the months to follow.

Patients also expressed that they sometimes did not know what services were available to them. We have started work on better signposting and staff training in this area and will work with our PPGs on ways to better communicate and raise awareness for patients.

Details of suggestions made and how we are acting on them can be seen overleaf in our ‘Key themes and recommendations’ section which we will also publish on our websites and display in waiting rooms.

6. What next?

We want to thank people for taking the time to share their views and helping us plan for the future. If we are granted permission our practices plan to merge on 1st April 2020 and patients will see the benefits of being a larger practice over the next few months. We will inform all our patients of the final decision regarding the merger by 20th February 2020 on our websites and by text messages where we have the patient details.

7. Key themes and recommendations

You said

We will / have

You can help us by

Continuity of care

Patients we spoke to said it was important to them that we kept the “personal” feel of both practices and that they were able to have continuity of care with a stable team of Clinicians.

We have been actively recruiting additional GPs and nurses who are looking for longer-term opportunities and we have already reduced the number of temporary locums used.

Being willing to see the next available clinician, rather than waiting for your usual one, when the matter is urgent and you could be seen sooner.

Patients wanted to be able to see their own GPs at their own Practice as they do now.

Maintain services so that patients can still access their preferred clinicians in their preferred location but with added flexibility and choice if they want to use it.

Being flexible in who you book to see whilst we strengthen our team.

Quality of care and services

Most people told us they were supportive of the merger because it will give them access to a wider range of services that are more sustainable.

We will progress with our plans for a merger, so that if we are given the go-ahead we are ready to merge in Spring 2020.

You can help us by joining our PPG and championing the voice of our registered patients.

There were some issues with repeat prescription processing and communicating with patients.

We have met with PPG representatives to understand the issues and have made changes to the process to improve this service.

Giving us constructive feedback when things aren’t working as they should, so that we can help.

You would like to see more clinics /services for certain health conditions and patient groups.

We have been trialling some group clinics for conditions such as Diabetes and we are planning a Coeliac clinic soon – watch this space!

Being open to new ways of self-caring.

Information and support

Some people told us that they were not aware of what services they could access at the practice and in the local community.

We will work with our PPG and staff on better ways to communicate and raise awareness of available services to registered patients.

You can help us by talking to our support staff before your appointment so that they can give you information about the best service to meet your needs.

Patients told us it was important to them that support staff were helpful, understanding and polite.

We will work with all of our staff over both sites to ensure high standards of patient care and respect (and sharing of good practice).

Always treating our support staff with the respect and kindness you wish them to show you.

Accessibility

Some people were worried that the merger will reduce the number of appointments available at each practice.

We will ensure that we continue to provide the same number of appointments, or more, every day.

You can help us by seeing your local pharmacy for common health conditions such as coughs, colds or earache.

Some people told us that they sometimes struggle to get through on the phone in the morning and when they do there are few or no appointments available.

We will look at all of the appointment systems for both practices and investigate improvements we can make to provide more on-the-day, pre-bookable and extended hours appointments as a result of the merger. We are also looking into a unified phone system to improve call handling but this is a longer-term project which we will consult with patients on before making any changes.

You can help us by using our online booking system and by calling after eleven for general enquiries.

You told us you want more appointments available out of core working hours.

You can help us by only using extended hours appointments if you are unable to attend during normal opening hours so that the early/late appointments are available for patients who have no other options.

You told us parking is an issue at both practices.

We will try to spread appointments and clinics out in a way that reduces the number of patients parking at the same time.

You can help us by only driving to your appointment if it’s necessary – coming on foot or using public transport instead where possible.

Appendix 1 – How we engaged with the public

ENGAGEMENT METHODOLOGY

How we will engage with our patients and community to share our plans with them and invite feedback:

This will take place during the engagement period: 1st to 30th November 2019.

Communication Tool

Mechanism and notes

Letter to all households with a registered patient.

Please note these letters will not be addressed to each individual patient but will make it clear that the letter is intended for any member of the household who is a registered patient at the respective GP practice. Please see below other ways we will engage with local people to ensure we give patients every possible opportunity to have their say.

A letter will be sent to each household which will update patients about what is happening in their practice, how they can have their say and the different methods for getting involved.

It will include a paragraph asking them to ensure that all members of the household registered with either practice are made aware of the contents.

The letters will state that it is available in different formats if needed and includes a helpful translation into the 5 main first languages (after English) prevalent in this locality and patient populations.

Letter to local community groups, religious groups and key figures etc

Assistance sought from community support networks to identify relevant local groups

Slightly amended version of letter to households to go out to community settings where patients may seek assistance translating or making sense of the info we have provided. Letter to explain all the same information given to patients but in different format – seeking support of those in the community in reassuring minority groups and individuals.

Information sent by text message

We will send out a text message to all registered patients where we have their mobile number.

The text message will state that we are looking at some changes and include a link to our respective websites for further information and to have your say.

Frequently Asked Questions

A sheet of 26 Frequently Asked Questions will be posted on both websites:

www.allertonmedicalcentre.co.uk and www.westfieldmedicalcentre.co.uk

and displayed in both practices to help further understanding of the merger for all involved. Information on how to access the FAQs sheet will be included in all patient communications.

Engagement survey

A short survey will be available for people to complete – this will be available online as well as in hard copy format. We will share details of how to access the survey with local partners, such as pharmacies or community groups, so that people who are not in regular contact with their GP practice can still access them.

www.allertonmedicalcentre.co.uk and www.westfieldmedicalcentre.co.uk

Again we will offer to make the survey available in alternative formats should anyone need this.

Option to call, email or write

Patients will be given the option to email, write or call to share their thoughts and comments.

Drop-in events

Anyone with any interest in the proposed merger is invited to our information and enagagements events:

Sat 23rd Nov11:00 – 13.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX 

Sat 24th Nov14:00 – 15.30Meeting Room, St. Matthew’s Church, Wood Lane, LS7 3QF

Mon 25th Nov 18.00-19.00  First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX 

Details provided on all relevant communications (letters to households and community groups, survey, posters, texts etc)

Patient participation groups

The patient participation groups for both practices have reviewed and signed off a merger engagement plan, the patient letter, FAQs and survey in order to ensure it covers all they feel it should and is in clear understandable language.

Poster

Information poster will be available at both sites as well as other community locations, to remind people to fill in the survey and give their views.

Press Releases

Briefing will sent to local press informing them of proposals and engagement exercise.

Information on websites

Dedicated information on both practice websites.

Appendix 2 – Letter to households

Date as postmark

RE: Important information about your GP Practice

We are writing to you as a patient or householder registered with either Allerton Medical Centre in Chapel Allerton or Westfield Medical Centre in Chapeltown. Please make sure you share this with everyone in your home that uses the medical centre.

As part of our commitment to providing the best possible service to our patients and local communities we are proposing to merge Allerton and Westfield Medical Centres on March 31st 2020. If the merger goes ahead you should see only see positive changes as a result.

You will remain a registered patient and will still be able to see the same Clinicians (Doctors, Nurses, Healthcare Assistants, Midwives etc) and Patient Support Staff in the same building as you do now. Both locations will remain open, you can use the same numbers to call us and no staff will be made redundant.

Opening times will remain the same and extended hours appointments will be available to all patients. All clinics and support services available to both practices will remain unchanged. You will be able to get your medications in the same way you do now and can still be seen the same day if you are really unwell.

We are keen to merge as we believe this will help to ensure the practice remains able to provide high quality services in the future as we manage mounting pressure in primary care. A larger patient base and staff base will help us deal with some of the challenges we face. It will put us in a better position to invest in our staff and their continued development as well as our facilities and equipment.

Other benefits we think you will see include:

· You are more likely to have continuity of care with a regular GP

· There will be more appointments available with a range of clinicians, not just GPs

· You can choose to access services/clinics at either site

· Staff can share knowledge and best practice, improving patient care

· There will be more GP and Nurse appointments as their administration will be shared

We want our patients to be involved – to have an opportunity to share your views and to help shape the future of this larger practice. Your feedback is important to us and can impact our proposed plans.

A patient survey to give us your thoughts (and ‘Frequently Asked Questions’ for your information) is available on both of our websites:

www.allertonmedicalcentre.co.uk and www.westfieldmedicalcentre.co.uk

You can also fill in a paper copy of the survey – available at your Practice Reception desk. Please ask there if you need an alternative format (e.g. braille) or need help with translation. The closing date for the survey will be 30th November 2019.

Alternatively come and chat to us with any ideas, queries or concerns at one of our drop-in events:

Sat 23rd November 11.00-13.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Sun 24th November14.00-15.30Meeting Room, St Matthew’s Church, Wood Lane, LS7 3QF

Mon 25th November18.00-19.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

We also welcome any comments or suggestions via the options below:

Email westfield@nhs.net or allerton.admin@nhs.net

Telephone 0113 4679744 (Westfield) or 0113 2953460 (Allerton)

A report showing feedback from this process will be available on both Practice websites by 23rd December 2019 and a final decision saying if the merger will go ahead will be added to the websites by 20th February 2020.

We care about the service we provide to patients and want to keep the personal approach central to both practices. Our decision to look at merging has been taken after careful consideration of how we can best serve patient needs. Comments from Partners included:

“We are passionate about this local community and have enjoyed providing their care over recent times. However working as such a small team no longer allows us to provide the best range of services and care for patients. Working more closely with other local practices will enable a better, more responsive and proactive range of care to be provided to Westfield patients. We are confident that merging with Allerton will allow those developments to occur whilst maintaining all the values that Westfield patients see as important.” Nick Nurden, Managing Partner – Westfield Medical Centre

"At Allerton Medical Centre, we take pride in the good old family practice, continuity of care and say 'small is (still) beautiful'. We are passionate about the wellbeing of our patients and staff, helping people to live longer in good health with a strong focus on working together. We have been working closely with Practices in Chapeltown for the last two years. General Practice is under so much pressure and our proposed merger will strengthen our work force and enable us to provide even higher quality healthcare to our patients while supporting initiatives to improve wellness in our local communities." Abiye Hector-Goma, GP Partner – Allerton Medical Centre

Please help us to make your Medical Practice even better!

---------------------------------------------------------------------------------------------------------------------------------------------

If you need help understanding this information in another language or format, please contact your medical practice اگر آپ کو کسی دوسری زبان یا شکل میں اس معلومات کو سمجھنے

میں مدد کی ضرورت ہو تو ، براہ کرم اپنی سرجری سے رابطہ کریں

Jeśli potrzebujesz pomocy w zrozumieniu tych informacji w innym języku lub formacie, skontaktuj się z recepcja

Dacă aveți nevoie de ajutor pentru înțelegerea acestor informații într-o altă limbă sau format, vă rugăm să contactați cabinetul medical

ਜੇ ਤੁਹਾਨੂੰ ਇਸ ਜਾਣਕਾਰੀ ਨੂੰ ਕਿਸੇ ਹੋਰ ਭਾਸ਼ਾ ਜਾਂ ਫਾਰਮੈਟ ਵਿਚ ਸਮਝਣ ਵਿਚ ਸਹਾਇਤਾ ਦੀ ਲੋੜ ਹੈ, ਤਾਂ ਕਿਰਪਾ ਕਰਕੇ ਆਪਣੇ ਡਾਕਟਰੀ ਅਭਿਆਸ ਨਾਲ ਸੰਪਰਕ ਕਰੋ

إذا كنت بحاجة إلى مساعدة في فهم هذه المعلومات بلغة أو صيغة أخرى ،

فيرجى الاتصال بممارستك الطبية

Appendix 3 – Community stakeholders contacted

The organisations below have been sent a copy of either the stakeholder brief or community letter (Appendix 4 and 5) either by email or post:

Leeds Medical Council

The Jamaica Society

Lees Black Elders Association

Association of Ukrainians in Great Britain

United Caribbean Association

Brackenwood Community Association

West Indian Community Centre

Little London Community Centre

St Matthews Church

Stainbeck Utd Reform Church

Chapel Allerton Methodist Church

Church Leeds

Church of God Of Prophecy

Harehills Lane Baptist Church

Bridge Community Church

St Aidan’s Church

Leeds Seventh Day Adventist Church

Leeds Cathedral / Holy Rosary

Leeds Islamic Centre

Polish Catholic Centre

Prince Philip Community Centre

Woodhouse Community Centre

Leeds Community Foundation

Archway

The Mandela Centre

Wat Buddharam (Thai Temple)

Leeds Gurdwara (Sikh Temple)

St Martins & Roscoe Church

Leeds City Council

Public Health Leeds

Leeds Faith Forum also passed our information on as appropriate

The organisations below have contacts on the Inner North Leeds contact list who were informed by email and sent Appendix 4 or 5

(and in turn they may have forwarded our information to their own appropriate contacts):

Turning Lives Around

Feel Good Factor

Voluntary Action Leeds

Black Health Initiative

Maecare

The Conservation Volunteers

Chapeltown Arts

Chapeltown Netball

One You

Leeds West Indian Community

Unique Improvements

Leeds Asylum Seekers Support Network

Leeds Irish Health & Homes

Zest Health for Life

Health for All

Space2

Connect Housing

Project Hope

Leeds Migration Support

Lemon Balm (Health & Wellbeing)

Oral Health

Curator.works

Leafield Tenants & Residents Assoc

Leeds Jewish Welfare Board

Yorkshire Sport

Meanwood Valley Baptist Church

Path Yorkshire

Leeds City Credit Union

Women’s Lives Matter

Leeds Confederation

Hamara Healthy Living Centre

Touchstone

Leeds Healthcare

Groundwork

Age UK

Interact

Unity Housing Association

RJC Dance youth provision

Also:

17 local GP Practices were individually emailed Appendix 4 and were also informed in the GP Bulletin (Primary Care Newsletter 7/11/19).

20 local Dentists were individually emailed Appendix 4.

All chemists in the area were informed in their Bulletin (Community Pharmacy West Yorkshire News Digest 7/11/19) and if the merger goes ahead will be informed on all prescriptions printed in March 2020.

The following Local Councillors were all sent Appendix 5:

Cllr Charlwood

Cllr Dowson

Cllr Goddard

Cllr Hamilton

Cllr Rafique

Cllr Shahzad

Cllr Taylor

Cllr Tunnicliffe

Cllr Wenham

Appendix 4 – Letter to community group/leader

RE: Important information about your local GP Practices Date as postmark

We are writing to you as a person or group in our local community who has links to patients registered with either Allerton Medical Centre in Chapel Allerton or Westfield Medical Centre in Chapeltown. Please can we ask for your assistance in sharing this information and ensuring it is fully understood by those you have contact with for whom it is relevant? Patient households have all been given the same information as you.

As part of our commitment to providing the best possible service to our patients and local communities we are proposing to merge Allerton and Westfield Medical Centres on March 31st 2020. If the merger goes ahead patients should see only see positive changes as a result.

Patients will remain registered with the Practice and will still be able to see the same Clinicians (Doctors, Nurses, Healthcare Assistants, Midwives etc) and Patient Support Staff in the same building as they do now. Both locations will remain open, patients can use the same numbers to call us and no staff will be made redundant.

Opening times will remain the same and extended hours appointments will be available to all patients. All clinics and support services available to both practices will remain unchanged. Patients will be able to get their medications in the same way they do now and can still be seen the same day if they are really unwell.

We are keen to merge as we believe this will help to ensure the practice remains able to provide high quality services in the future as we manage mounting pressure in primary care. A larger patient base and staff base will help us deal with some of the challenges we face. It will put us in a better position to invest in our staff and their continued development as well as our facilities and equipment.

Other benefits we think patients will see include:

· They are more likely to have continuity of care with a regular GP

· There will be more appointments available with a range of clinicians, not just GPs

· They can choose to access services/clinics at either site

· Staff can share knowledge and best practice, improving patient care

· There will be more GP and Nurse appointments as their administration will be shared

We want our patients and members of our community to be involved – to have an opportunity to share their views and to help shape the future of this larger practice. Your feedback and that of our patients is important to us and can impact our proposed plans.

A patient survey to give us your thoughts (and ‘Frequently Asked Questions’ for your information) is available on both of our websites:

www.allertonmedicalcentre.co.uk and www.westfieldmedicalcentre.co.uk

You/they can also fill in a paper copy of the survey – available at either Practice Reception desk. Please ask there if you/they need an alternative format (e.g. braille) or need help with translation. The closing date for the survey will be 30th November 2019.

Alternatively you/they can come and chat to us with any ideas, queries or concerns at one of our:

Drop-in events:

Sat 23rd November 11.00-13.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Sun 24th November14.00-15.30Meeting Room, St Matthew’s Church, Wood Lane, LS7 3QF

Mon 25th November18.00-19.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

We also welcome any comments or suggestions via the options below:

Email westfield@nhs.net or allerton.admin@nhs.net

Telephone 0113 4679744 (Westfield) or 0113 2953460 (Allerton)

A report showing feedback from this process will be available on both Practice websites by 23rd December 2019 and a final decision saying if the merger will go ahead will be added to the websites by 20th February 2020.

We care about the services we provide and want to keep the personal approach central to both practices. Our decision to look at merging has been taken after careful consideration of how we can best serve patient needs. Comments from Partners include:

“We are passionate about this local community and have enjoyed providing their care over recent times. However working as such a small team no longer allows us to provide the best range of services and care for patients. Working more closely with other local practices will enable a better, more responsive and proactive range of care to be provided to Westfield patients. We are confident that merging with Allerton will allow those developments to occur whilst maintaining all the values that Westfield patients see as important.” Nick Nurden, Managing Partner – Westfield Medical Centre

"At Allerton Medical Centre, we take pride in the good old family practice, continuity of care and say 'small is (still) beautiful'. We are passionate about the wellbeing of our patients and staff, helping people to live longer in good health with a strong focus on working together. We have been working closely with Practices in Chapeltown for the last two years. General Practice is under so much pressure and our proposed merger will strengthen our work force and enable us to provide even higher quality healthcare to our patients while supporting initiatives to improve wellness in our local communities." Abiye Hector-Goma, GP Partner – Allerton Medical Centre

Please help us to make these Medical Practices even better!

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------

If you need help understanding this information in another language or format, please contact your medical practice اگر آپ کو کسی دوسری زبان یا شکل میں اس معلومات کو سمجھنے

میں مدد کی ضرورت ہو تو ، براہ کرم اپنی سرجری سے رابطہ کریں

Jeśli potrzebujesz pomocy w zrozumieniu tych informacji w innym języku lub formacie, skontaktuj się z recepcja

Dacă aveți nevoie de ajutor pentru înțelegerea acestor informații într-o altă limbă sau format, vă rugăm să contactați cabinetul medical

ਜੇ ਤੁਹਾਨੂੰ ਇਸ ਜਾਣਕਾਰੀ ਨੂੰ ਕਿਸੇ ਹੋਰ ਭਾਸ਼ਾ ਜਾਂ ਫਾਰਮੈਟ ਵਿਚ ਸਮਝਣ ਵਿਚ ਸਹਾਇਤਾ ਦੀ ਲੋੜ ਹੈ, ਤਾਂ ਕਿਰਪਾ ਕਰਕੇ ਆਪਣੇ ਡਾਕਟਰੀ ਅਭਿਆਸ ਨਾਲ ਸੰਪਰਕ ਕਰੋ

إذا كنت بحاجة إلى مساعدة في فهم هذه المعلومات بلغة أو صيغة أخرى ،

فيرجى الاتصال بممارستك الطبية

Appendix 5 – Stakeholder Briefing Note

Briefing Note: Proposed merger of Allerton Medical Centre and Westfield Medical Centre

This briefing note is for local councilors, MPs, local pharmacies, other local GP practices, voluntary sector organisations and any other people or services with an interest in the proposed changes.

We wanted to provide you with an update on our two GP practices both of which are in the LS7 (Chapeltown) locality. The Practices are:

· Allerton Medical Centre –situated in a converted house with extension and portakabin at 6 Montreal Avenue, Chapel Allerton, LS7 4LF. Allerton currently has around 6,000 patients, with 3 GP Partners and 2 Salaried GPs and is CQC-rated ‘Good’.

· Westfield Medical Centre – situated on the First Floor, The Reginald Centre, 263 Chapeltown Road, LS7 3EX (in a leased area of a large Health Centre that also hosts other community services such as a pharmacy, library and café) currently has around 4,300 patients, with 1 acting GP Partner and 2 Salaried GPs (and is also CQC-rated ‘Good’).

Our proposal is that Allerton Medical Centre and Westfield Medical Centre are merged. We strongly believe that the merger will bring benefit to patients, staff and GP partners. We care about the services we provide and want to keep the personal approach central to both practices. Our decision to look at merging has been taken after careful consideration of how we can best serve patient needs.

We have outlined the benefits of the proposed merger below:

· Patients are more likely to have continuity of care with a regular GP as we reduce locums and recruit permanent clinicians across both sites

· The merged practice will be a more attractive prospect when recruiting higher calibre staff and Partners

· More appointments will be available with clinicians as their administration will be shared, freeing up more time for their patient-facing roles

· Patients registered at either of our surgeries will be able to choose from appointments at both sites for their convenience

· Patients will have access to a wider healthcare workforce with a broad range of clinical expertise as we can share staff and resources across sites and hire into more varied roles

· By having access to a broader range of healthcare professionals and increased appointments, we will be in a better position to meet the evolving needs of our patients

· The proposed merger will ensure future sustainability of the two practices and is in line with the NHS GP Five Year Forward View

· We will have better contingency arrangements to provide mutual aid such as during any periods of staff sickness

· The whole practice team from clinicians to office staff will benefit from a wider support network

· We will be able to offer extended hours appointments to all patients

· We are committed to developing and retaining our staff - the proposed merger will offer greater flexibility to allow staff time to undertake continued professional development due to the contingency arrangements in place

· Reduction in back-office administration through economies of scale

· Enables us to work even more effectively with other practices in our locality to provide community-wide healthcare solutions

At this stage this is only a proposal that would need to be approved by NHS Leeds Clinical Commissioning Group based on a strong evidence base for change as well as engagement with all our key audiences including, but not limited to our patients and staff.

If we progress with our proposal then we would look to implement this on 31st March 2020.

We wanted to make our employees, patients and stakeholders aware of the proposal at the earliest possible opportunity. It is important to stress the following points at this stage:

· We are not proposing any changes that directly affect the location of the two sites and as such both will remain open.

· Our proposals will not result in any staff members being made redundant, nor will any of their terms and conditions of employment change as a result of the merger. We will of course listen to any concerns raised by staff and look to address these.

· Patients can be reassured that at the merger date they would: remain registered with the merged Practice; be able to see their usual clinicians in their usual building if they prefer; access services using the same phone numbers, during the same core hours; get their medications in the same way; and still be seen the same day if really unwell.

Engaging with patients

We are keen to merge as we believe this will help to ensure the practice remains able to provide high quality services in the future as we manage mounting pressure in primary care. A larger patient base and staff base will help us deal with some of the challenges we face. It will put us in a better position to invest in our staff and their continued development as well as our facilities and equipment.

However we want to ensure that our belief is shared by the practice populations and therefore our aim is to have a robust process in place for engaging with patients. You can find a copy of our engagement methodology, detailing each of the communication tools and mechanisms we are using to engage with our patients and community, on both practice websites and displayed in both practices. These include letters to households, a survey, text messages and letters to stakeholders.

This isn’t just an exercise to find out what concerns people have but an opportunity to encourage local people to make suggestions that could help improve the services provided by our practices. Your feedback and that of our patients is important to us and can impact our proposed plans. We also feel this offers an opportunity to potentially broaden the representation on our respective patient participation groups in an effort to recruit a wider pool of patient volunteers.

Timings

We will be asking patients for their views from 1st to 30th November 2019. A report showing feedback from this engagement process will be available on both practice websites by December 23rd 2019 and a final commissioning decision regarding whether or not the merger will go ahead will be available on both websites by 20th February 2020.

To get involved

A survey to give us your thoughts (and ‘Frequently Asked Questions’ for your information) is available on both of our websites:

www.allertonmedicalcentre.co.uk and www.westfieldmedicalcentre.co.uk

and is available as a paper copy at either Practice Reception desk. Please ask there if you need an alternative format (e.g. braille) or need help with translation. The closing date for the survey will be 30th November 2019.

Alternatively you can come and chat to us with any ideas, queries or concerns at one of our:

Drop-in events:

Sat 23rd November 11.00-13.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Sun 24th November14.00-15.30Meeting Room, St Matthew’s Church, Wood Lane, LS7 3QF

Mon 25th November18.00-19.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

We also welcome any comments or suggestions via the options below:

Email westfield@nhs.net or allerton.admin@nhs.net

Telephone 0113 4679744 (Westfield) or 0113 2953460 (Allerton)

Appendix 6 – Example of engagement with PPGs

PPG Questions and Answers regarding Engagement Plan

PPG QUESTION

1. “Background. How assured our existing patients will be able to see the GP of their choice. I hear a lot about big practices where patients can rarely see the same GP twice.”

ANSWER

Firstly, let me clarify that we are not aiming to be a “big practice”. There are a lot of the super-practice style mergers going on in the country where the aim is to get as many patients as possible processed as quickly as possible by whichever clinician is available next. That is not what our merger is about. It is absolutely central to all of our plans that we maintain the feeling of personal service and patient-doctor relationship that both Allerton and Westfield currently pride themselves on. We think that “small is beautiful” but we recognise that it’s possible to be more efficient behind the scenes by joining forces within the same locality. I know from talking to the Partners at both Practices that this shared ethos is one of the reasons why they chose to collaborate with each other rather than alternative Practices. We want to ensure that patients have the opportunity to access a STABLE and supportive workforce and we are already working on reducing the number of locum doctors used at both sites and recruiting the right clinicians to fill any gaps. We believe that by joining forces we can attract the best like-minded clinicians and we can free up more GP time to offer more appointments. Also, it is worth stressing that we currently have no plans to move any of the GPs around. We are keen that any changes the patients will see over the next 6, 12 and 18 months are improvements that have come about through evolution, not revolution – with input from staff, patients and doctors. The plan is that patients at both sites will have more, rather than less, choice of which GP, Nurse (and potentially even Advanced Nurse Practitioner or Prescribing Clerk) to see.

PPG QUESTION

2. “Level of change..... Not sure exactly what this describes. It says it's an info giving engagement, and people can express concerns, but will any notice be taken of them?”

ANSWER

It’s worth noting that the documentation I have shared with you is the same standard documentation required by our commissioning group that is necessary in high risk mergers with staff being made redundant and sites being closed down. Therefore it can sometimes look like we are (to use one of Lindsay’s phrases) “using a pneumatic drill to core an apple”. The question basically should say “What changes will patients see from day 1”. This project is very low risk, very low impact – we wouldn’t really even talk about change if we didn’t need to because it makes it seem like a bigger deal for patients than it actually is. Essentially we are still planning to run 2 separate sites almost exactly as they are now but making adjustments and improvements over time (with input from everyone involved) in order to benefit from being one business instead of two.

We will always take notice of patient opinion – our role is to provide the best possible services to meet patient needs so I promise we will be listening. It’s part of my job as Project Manager of the merger to canvas patient and stakeholder feedback and let you know how and where your feedback has been acted on.

PPG QUESTION

3. “Timescale. 

Clear, but are they realistically achievable?”

ANSWER

I hope so as it’s my job to deliver it all! Joking aside, I know that the timescales are tight but we don’t have much choice in those as we want to ensure that our patient engagement period is as long as possible to give everyone the chance to give feedback. We need to submit all the relevant documentation and assurances to the Commissioning Group to hit their deadlines for meetings in order to get everything signed off to merge our NHS contracts next Spring. My time is dedicated entirely to this merger, whilst your Practices are ran by your capable staff and Managers, and I’ve dealt with mergers like this before in the same timeframes. A lot of the legal and HR aspects have been looked at already whilst we have been awaiting permission from the Commissioners to engage with you so we are on track to date. If we can get all of the letters to households and stakeholders out in the first week of November we will be fine – and with your help we can definitely do that!

PPG QUESTION

4. “Who is affected..... 

You say everyone will be affected but no indication as to how. 

Will all patients currently registered remain registered?” 

ANSWER

All patients currently registered with Allerton or Westfield Medical Centres will remain registered patients of the one merged Practice – they will not need to re-register. In the Spring when/if the plans go ahead and we merge the contracts all of our patients will be accessible on the same clinical system on our computers from either site. Patients will still be able to access the same services and get their medications and reviews in the same way.We plan to keep both phone numbers to ring the Practices, we plan to keep both sites working and all the existing support staff. We plan for patients to be able to choose which site they access services at. Any changes we make will impact on all patients alike but we haven’t consulted with the patients and staff yet to know what those changes might look like. For example - we don’t know yet what the merged Practice will be called or whether we will keep the existing Practice names under an umbrella name – those are the kind of decisions that will come through the consultation and planning process between now and the contract merge.

PPG QUESTION

5. “Methodology... 

What response rate are you expecting given you are going to do a number or ways of patient involvement during the process?”

ANSWER

Honestly, pretty low. Despite going to great lengths to engage with as much of the patient population as possible the response rate, in my experience, is usually less than 5%. We will ensure that we have made the information accessible to everyone including solutions to deal with barriers caused by language and disability but it’s up to the patients to get involved if they want to have any input. I find PPG members invaluable in this process as they are used to speaking on behalf of the members of the patient population who, for whatever reason, are unable or reluctant to engage. We will endeavour to make every effort to get as many responses as possible though and make the process meaningful.

PPG QUESTION

6. “Partnership working... 

Are you going to expand the input of other professionals, and if so what else will be added. How will patients know what is available?” 

ANSWER

This section of the plan refers more to ensuring the involvement of existing stakeholders in the consultation aspect of the merger. In the same way that we want to make sure that we inform all of our patients of the planned merge and give them a chance to offer input, we also want to include all the relevant local groups, organisations and businesses that it may impact on.

The merged Practice (and the separate Practices in the meantime) will/are constantly looking at how patients can be positively impacted by the input of other professionals and complimentary services. I know that your local group of Practices is doing some fabulous work looking at the services that would benefit your community as a whole and how they can collectively support the provision of these services. We can ask patients as part of this process what other professionals they would value input from and how they think it would be best to communicate with them regarding available services - however I think that’s more part of the evolution post-merger I mentioned earlier than this section of the plan.

PPG QUESTION

7. “Engagement questions. 

Doesn't the patient survey just done cover a lot of this?” 

ANSWER

Quite possibly but we still need to have a survey with aspects specific to the merger process. The Clinical Commissioning Group are assisting with the distribution of the survey and collation of results so some of the questions posed on p1 are for their purposes and may duplicate some asked previously. To be honest though, it is useful information to collect again as they will be looking at how/if responses change over time too. The section we are really interested in is the questions on p2. We want to ask a few open-ended questions regarding the merger plans to give everyone the opportunity to have their say. Our plan is to encourage people by asking 3 very generic questions so they are free to give whatever feedback they like. Therefore it’s likely the questions will be:

· What do you like about the merger plans?

· Tell us if you have any concerns about the merger plans…

· Tell us what improvements you’d like to see as a result of the merger…..

Appendix 7 – Frequently Asked Questions

GP Practice merger – Westfield and Allerton

Frequently Asked Questions (FAQs)

1. When will the proposed merger take place?

We are aiming to merge the practices on 31st March 2020 (to coincide with year ends).

2. Will I still be able to make an appointment to see my usual doctor or nurse?

Yes. We very much value all of the one to one relationships our patients have with our doctors and nurses. It is therefore expected that merging practices will further increase our ability to provide you with continuity of care and access to your usual doctor and/or nurse.

We also expect to be able to reduce the need for locum doctors and provide you with a greater number of highly skilled local doctors and nurses in the event that your usual doctor or nurse is absent from work.

3. Will I still be able to make appointments to be seen at my usual doctor’s surgery?

Yes. We will continue to provide daily appointments to see doctors, nurses and healthcare support workers at your GP practice.

4. Will I be able to make appointments to see a doctor/nurse at the other site?

As our plans fully develop, we expect that you will be able to request appointments with any doctor and/or nurse from either practice site, therefore providing you with greater access to a wider range of services and availability. We will regularly assess demand across both sites and look at where appointments are needed most.

5. Will my usual surgery opening times stay the same?

Yes. We are not currently anticipating any changes to our core opening times. We also expect to be able to improve and extend our opening times for all of our patients.

6. Will there be changes made to the way I book appointments?

No. We are not currently anticipating any changes to the way you book appointments and you will therefore continue to be able to book these in the same way as you do now.

As now, we will also continue to contact all of our patients who require scheduled vaccinations, chronic disease reviews or routine screening such as cervical screening tests.

7. Will I still ring the same number I always have?

The telephone numbers will remain the same. We may look at a single telephone system for both sites in the future but we are keen to keep both existing numbers and make the system as simple for patients to use as possible.

8. What will be merged Practice be called? Will the name of my Practice change?

No decisions have been made yet regarding the names of the sites or name of the proposed merged practice. We will be considering this over the coming months but think it likely that the two sites will retain their current practice names.

9. Will the current arrangements that I have in place for getting my medicines stay the same?

Yes. There are no changes anticipated at present and any future changes in process will be fully communicated to patients.

10. Will the intended merge affect any treatment or medication I am currently receiving either at my usual surgery or any hospital?

No. Any current treatments, medications, investigations and/or referrals will not be affected by our intentions to merge.

11. Will I need to re-register to become a patient of the single GP Practice? What will happen to my health records?

No, you will not need to re-register and we also anticipate that you will keep the same named GP you have now. All of our patients will automatically be merged into a single GP Practice and your health records will reside within a single patient database.

The NHS safeguards in relation to patient confidentiality of information will continue to remain in place throughout the transition.

12. Will the single GP Practice be able to provide new services to patients?

One of the main reasons to merge and form a larger practice is for us to be able to expand the services that we are able to provide locally. For example, we hope to be able to include access to see other healthcare professionals e.g. Prescribing Clerks for medication reviews and Advanced Nurse Practitioners.

13. How will the new arrangement benefit GPs and Nurses at the practice?

Our GPs, Nurses and Healthcare Support Workers will all have access to a wider pool of clinical knowledge and expertise to draw upon and we will have far greater opportunities to specialise in areas such as diabetes, care of the elderly, palliative care and urgent care access.

We also anticipate that the current level of administrative tasks our clinical staff performs will be dramatically reduced; therefore allowing more time to spend on responding to and delivering the clinical care our patients need.

We will also be able to better cover any planned or unplanned absences which we hope will alleviate the resulting pressures felt by remaining staff. In addition, we should also be able to reduce our reliance on expensive locum and bank staff.

We also anticipate that all of our staff will be provided with greater opportunities for enhanced training and career development.

14. Will any staff be made redundant?

No. All staff will continue to be employed as they are now. We are actually recruiting to ensure we have a full workforce covering both sites.

15. Will patients have to wait longer for appointments?

No. On the contrary. As part of the merger we will be looking at appointments offered across both sites and plan for there to be more appointments and choice for patients. With a more varied workforce it should be easier to book an appointment with the best person to treat you.

16. Will any service that is currently offered by my usual surgery be removed or stopped?

No. We do not anticipate services being removed or stopped. If anything, we anticipate that this merger will bring about a greater choice of services.

17. Will I have to go to another GP Practice site for consultations and/or treatments?

No. However, if in the future we feel that one of the sites provides a better or more appropriate service for specific patients – for example a particular doctor at one site may specialise in COPD or diabetes – you may be asked if you would like to attend there in order to access more specialised care if this is appropriate and you choose this option.

18. Will there be any changes to how I access the GP out of hours service?

No. In order to access a GP when the merged practice is closed, you will still continue to telephone the NHS 111 service and they will either signpost you to the most appropriate service or arrange for you to access a GP.

19. Is there a risk of the practices going private?

No. It would not be in line with the vision and ethos of either practice to consider this an option. This is another reason for merging. There is a national shortage of doctors and practices with more opportunities are more appealing to doctors looking for a practice to join.

20. What will happen with our Patient Participation Groups?

The PPG members from both practices are currently discussing the options for the PPGs going forwards. We hope this may be a good opportunity to merge the two groups and represent the patients from our whole locality in one PPG. We look forward to sharing the outcomes of the current discussions with our patients.

21. If we don’t merge what will the future look like?

General practice is seeing a substantial increase in demand coupled with fewer doctors choosing a career in primary care. In order to ensure we can continue to provide a high standard of care that is sustainable for the future the partners at both practices believe this merger needs to happen.

22. Will the merged practice merge again with more practices in the future?

We do not currently have any plans to merge again after this merger. However, we already work closely with other practices in our locality and see the benefits of working together in a variety of ways. It will always be of the utmost importance to our Partners and staff that other practices we work with share our personal, patient-centred approach.

23. Who makes the final decision? Is it already a ‘given’ that it will go ahead?

This is all still a proposal at this stage. We have only been given permission to consult so far. After everyone has been informed of the plans and given the chance to give feedback the practices will produce a final report to be submitted to the commissioners. A copy of the report will be posted on both websites by 23rd December. When a final decision has been made we will update the websites again (by 20th February 2020).

24. Will my feedback be listened to?

Yes. We really value the input our patients and stakeholders can contribute to this process. We are trying to provide the best possible service to meet our patient and community needs so it helps us to know what you would like to see and why.

25. How will I know when the merger has taken place?

Once the merger has been agreed we will contact all our patients by text (if we have appropriate details/consent) to keep them informed of progress. We will also update both Practice websites.

26. I have further questions I would like to ask and / or comments I would like to make. How do I do this?

You can put these in writing for the attention of the Nikki Ibbotson at your usual surgery.

You can also submit any questions and/or comments to A/O Nikki Ibbotson at either Practice email address westfield@nhs.net or allerton.admin@nhs.net

We will aim to respond to any questions / comments within 10 working days of receipt.

Appendix 8 – Engagement Information Poster

We are proposing to merge Allerton Medical Centre and Westfield Medical Centre

Tell us your thoughts in our patient survey (link on our website) or paper copy from Reception

Or come and chat at one of our:

Drop-in events:

Sat 23rd Nov 11.00-13.00 First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Sun 24th Nov 14.00-15.30Meeting Room, St Matthew’s Church, Wood Lane, LS7 3QF

Mon 25th Nov 18.00-19.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Appendix 9 – Press Releases

The first press release below was sent to Yorkshire Evening Post who printed their article on 7th November 2019, which can be viewed on the following link:

https://www.yorkshireeveningpost.co.uk/health/two-north-leeds-gp-surgeries-become-one-practice-bid-ensure-future-viability-861316

The second edited press release was sent to North Leeds Life for their December issue (after the engagement exercise – just for information) as the deadline for the November issue was in October, before the engagement began. The article can be seen in the Group B publication (distributed in LS7,LS8 & LS17) on PAGE 26 in the following link:

http://www.northleedslifegroup.com/magazines/december-2019/

NORTH LEEDS PRACTICES SET TO MERGE TO ENSURE SUSTAINABLE SERVICES FOR PATIENTS

Two well-established GP practices in North Leeds, Westfield Medical Centre and Allerton Medical Centre are planning to merge in order to improve and future-proof safe, effective and sustainable primary care for their local population.

The two surgeries intend to become one practice next spring as part of their commitment to providing the best possible service to their patients and local community. They will remain in their current buildings and patients will have continuity of care with a named GP, while having the flexibility to access additional services at either of the two sites. The merger will be subject to all regulatory approvals and appropriate levels of engagement with patients and staff.

Doctors say the decision has been taken after careful consideration to help ensure the future viability of the practices whilst protecting and enhancing patient care. A larger patient base and staff base will help them deal with some of the challenges they face, putting them in a better position to invest in staff, and their continued development, as well as facilities and equipment.

Nick Nurden, Managing Partner at Westfield Medical Centre said “We are passionate about this local community and have enjoyed providing their care over recent times. However working as such a small team no longer allows us to provide the best range of services and care for patients. Working more closely with other local practices will enable a better, more responsive and proactive range of care to be provided to Westfield patients. We are confident that merging with Allerton will allow those developments to occur whilst maintaining all the values that Westfield patients see as important.”

The partners say they know from experience that both practices have like-minded values and share the same ethos and vision for patient services. Other benefits they cited of the proposed merger included that one united practice will allow them to attract and retain new talent, across both clinical and support staff. They believe this will result in a reduction in locum doctors, the reduction of administration per clinician and a resultant increase in appointments and out of hours and urgent care capacity. They also described how sharing staff expertise and best practice across all functions with greater training and career development will provide them with multiple opportunities to work at scale. In particular it will allow them to support GP’s special interests and in turn provide more in depth specialist health services such as palliative care, diabetes, care of the elderly and urgent care.

GP Partner at Allerton Medical Centre, Abiye Hector-Goma (pictured) added that "At Allerton Medical Centre, we take pride in the good old family practice, continuity of care and say 'small is (still) beautiful'. We are passionate about the wellbeing of our patients and staff, helping people to live longer in good health with a strong focus on working together. We have been working closely with Practices in Chapeltown for the last two years. General Practice is under so much pressure and our proposed merger will strengthen our work force and enable us to provide even higher quality healthcare to our patients while supporting initiatives to improve wellness in our local communities.”

To help people understand more about the proposed merger, the practice is holding three drop in events on the following dates:

Sat 23rd November 11.00-13.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Sun 24th November14.00-15.30Meeting Room, St Matthew’s Church, Wood Lane, LS7 3QF

Mon 25th November18.00-19.00First Floor, Reginald Centre, 263 Chapeltown Rd, LS7 3EX

Anyone interested can also complete a survey online by visiting either practice’s website: www.allertonmedicalcentre.co.uk and www.westfieldmedicalcentre.co.uk or can pick up a paper copy of the survey by visiting their local GP practice.

Q What will this mean for me as a patient?

There will be no change to standard GP services. Over time, we aim to increase the services available in order to improve our patient’s access primary care services.

Q Why is this happening now?

The demands being placed on primary care services means that practices need to look at ways to sustain the services being offered. The practices want to take positive steps to come together in a planned way since we all expect that this will be happening more generally across the NHS in the future. This allows us to pass the full benefit of technological and medical service development to all our patients and improve the quality of care available at both locations.

Q Will there be a reduction in local GP services?

No. Our intention is to initially sustain the services that we offer and to progressively work towards increasing the number of services available to our patients.

Q Will any of the surgeries close?

There is no intention to alter the location of any of the surgeries. However we do recognise that local planning developments, changes in service requirements and service demand may alter our locations over time.

Q Will staff be made redundant?

Staff