City of York Council Health and Adult Social Care Policy and Scrutiny Committee
19 March 2020
Practice Merger
Application
Jorvik Gillygate Practice and East Parade Medical Practice
Report Prepared by:
David Iley, NHS England and NHS Improvement (North East and Yorkshire)
1.) Background
Jorvik Gillygate Practice (The Stonebow, York, YO1 7NP) and East Parade Medical Practice (89 East Parade, York, YO31 7YD) have requested to merge their General Medical Service contracts from 1st May 2020. One of the key drivers for the merger is the imminent retirement of Dr Murray who is the sole provider at East Parade Medical Practice. Therefore, the merger will help ensure a more resilient primary care service in York. The Vale of York Clinical Commissioning Group are supportive of the merger and are working with NHS England and NHS Improvement to manage the process.
2.) Overview of how the Practices are merging
· Jorvik Gillygate Practice and East Parade Medical Practice are currently two separate General Medical Service contract holders both situated in the City of York area, 1.1 kilometres apart.
· Jorvik Gillygate Practice is run by 12 partners and has a growing patient population of 21,457.
·
East Parade Medical Practice has one partner and one
salaried GP jointly employed by East Parade Medical Practice and
Jorvik Gillygate Medical Practice; they have a growing population
slightly more than 2,400.
· Due to the planned retirement of Dr Chris Murray (sole provider at East Parade) it is proposed that there be a formal merger of the two contracts creating a single partnership operating under one single contract and maintaining a single registered list of patients.
· The merger would be affected through simultaneous termination of the East Parade Medical Practice contract and the variation of the Jorvik Gillygate Medical Practice contract to incorporate the East Parade Medical Practice as a branch site named Jorvik Gillygate East Parade branch. This will become a second branch site for Jorvik Gillygate Medical Practice.
·
Upon completion of the merger the Practice will continue to
operate over 3 sites as they currently are:
o Main site – The Stonebow, York, YO1 7NP
o Branch site – South Bank Medical Centre, 175 Bishopthorpe Road, York, YO23 1PD
o Branch site – East Parade Medical Practice, 89 East Parade, York, YO31 7YD
· Due to the current staff sharing arrangements between the two practices and both practices being in the same Primary Care Network this is seen as a natural progression. It will also enable the management of Dr Murray’s retirement and increase the resilience of the two practices whilst maintaining continuity of care for the patients who will benefit from the practices working at scale.
· Dr Murray will remain a salaried GP with Jorvik Gillygate until his retirement ensuring continuity for his patient list. The partnership of the new merged contract will comprise of the existing partners of Jorvik Gillygate Medical Practice.
3.) Key benefits to patients
· The merger will result in increased opening hours at the East Parade site whilst also allowing the Practice to extend the online consultations service currently offered at Jorvik Gillygate making the East Parade site service more accessible to its patients.
· Plans to add two additional consultation rooms to the East Parade site will allow the Practice to increase the number of clinicians/appointments.
· Patients at East Parade Medical Practice will have access to a wider range of enhanced services.
· Whilst many patients will continue to receive the majority of their care from their existing practice site in the short term the Practice will be redesigning services to deliver some appointments in the most appropriate places e.g. specialist clinics
· The workforce as a merged practice will allow for the adaptation of new models of access at the East Parade site such as Physician Associates, Clinical Pharmacists & ACPs.
· Jorvik Gillygate’s online and social media presence which shares practice news and health awareness promotions will become more accessible to East Parades patients and staff.
· The merger will allow for the streamlining of processes across the fully merged patient list to support an improvement in patient outcome.
· The merger will ensure the avoidance of the practice patient list at East Parade being dispersed when Dr Murray retires which would cause unplanned pressures on the surrounding area/practices and anxiety for patients.
· Jorvik Gillygate is currently an approved training practice. The merger will allow Jorvik Gillygate to increase the number of trainers in the merged practice.
4.) Comms and Engagement
The Practice have been working with the Vale of York CCG
Comms team around the engagement strategy. The key messages the
merged Practice want to communicate are;
·
Together we can provide excellent primary care services to
the combined patient population
·
Patients will experience greater access to care through a
choice of locations and services
·
Continuation of good quality general practice service
within the local economy
·
Our patients will receive a consistent offer of services
across a significant geographical and population base.
· Improvement of access to our patients utilising different methods of contact.
Engagement with the key stakeholders has been mapped as
follows;
To
engage the patients
·
PPG engagement, organise patient engagement events for all
patients who wish to hear more about the merger. Have a Practice
open day
·
Update patient information on our websites, in the practice
and online media i.e. Facebook in respect of the merger and asking
patient to feedback their concerns
·
Make available the results of the consultations to all
patients
·
Feedback to patients via the website, online media,
practice information leaflets, posters and any other resources any
updates as the merger progresses.
To
engage the Local Community & Practices
The practices recognise that a wider engagement strategy will take place with the local community strategy which we operate within.
·
Contact all local voluntary and other citizen forums to
inform them of the merger and to invite questions.
· In respect of local practices we anticipate that we will be able to inform them via our CCG newsletter and at the next Practice Managers meeting.
·
Liaise with Healthwatch York inviting them to attend our
engagement events.
·
Open up engagement sessions planned to the community
To engage
with staff
· All staff meetings to be held to engage with staff
Patient facing FAQs are available in Annex 1
5.)
Mobilisation
The Practice has developed a mobilisation plan available as Annex 2
6.)
Practice details and intentions for the merged
Practice
Below is a table demonstrating how the 2 existing contracts provide services and how the merged Practice will operate
|
Current Provision – Practice 1 |
Current Provision – Practice 2 |
Merged Practice |
Name and address of practice (provide name and address) |
Jorvik Gillygate Practice Woolpack House The Stonebow York YO1 7NP |
East Parade Medical Practice 89 East Parade York YO31 7YD |
Jorvik Gillygate Practice Woolpack House The Stonebow York YO1 7NP |
Contract type (GMS, PMS, APMS) |
GMS |
GMS |
GMS |
Name of contractor(s)
|
Jorvik Gillygate Practice |
East Parade Medical Practice |
Jorvik Gillygate Practice |
Location (provide addresses of all premises from which practice services are provided) |
Woolpack House The Stonebow York YO1 7NP & South Bank Medical Ctr. 175 Bishopthorpe Rd York YO23 1PD
|
89 East Parade York YO31 7YD |
Woolpack House The Stonebow York YO1 7NP & South Bank Medical Ctr. 175 Bishopthorpe Rd York YO23 1PD & East Parade Medical Practice 89 East Parade York YO31 7YD |
List size (provide figure) |
21,457 |
2,400 |
23,857 |
Number of GPs and clinical sessions (provide breakdown) |
14 GPs (1 GP jointly employed with East Parade) - 80 Clinical sessions per week 2 Pharmacist/ACP – 10 Clinical sessions per week 3 Physician Associates – 24 Clinical sessions per week 1 Pharmacist – 4 Clinical session
|
2 GPs (1 GP jointly employed with East Parade) – 11 Clinical sessions per week |
15 GPs - 91 Clinical Sessions per week 2 Pharmacist/ACP – 10 Clinical sessions per week 3 Physician Associates – 24 Clinical sessions per week 1 Pharmacist – 4 Clinical session |
Number of other practice staff (provide breakdown) |
1 Managing Partner 1 Business & Finance Manager 1 IT Manager 1 Rota Administrator 3 Secretaries 6 Read coder/Summariser 1 Compliance Assistant 1 Medical Report Clerk 2 Reception Team leaders 12 Receptionists 2 Receptions/Prescription Clerks 3 Apprentices 2 Cleaners 1 Maintenance person Please note numbers are not WTE but actual numbers of staff and some staff work have dual roles |
1 Practice Manager 1 Secretary 3 Receptionists Please note numbers are not WTE but actual numbers of staff |
1 Managing Partner 1 Project Manager 1 Business & Finance Manager 1 IT Manager 1 Rota Administrator 4 Secretaries 7 Read coder/Summariser 1 Compliance Assistant 1 Medical Report Clerk 15 Receptionists 3 Receptions/Prescription Clerks 3 Apprentices 2 Cleaners 1 Maintenance person Please note numbers are not WTE but actual numbers of staff and some staff work have dual roles |
Number of hours of nursing time (provide breakdown) |
135.5 hrs of Practice nurse time per week 111 hrs of HCA/HCA apprentice time per week |
20hrs Practice nurse time supplied by Jorvik Gillygate |
155.5 hrs of Practice nurse time per week 111 hrs of HCA/HCA apprentice time per week |
CCG area(s) (list CCG(s) in which practices are located) |
VoY CCG |
VoY CCG |
VoY CCG |
Which computer system/s (list system(s) used) |
EMIS |
EMIS |
EMIS |
Clinical governance/ complaints lead and systems (provide names) |
Clinical Governance = Dr Sarah Eaton Complaints Leads Dr Carolyn Forrest clinical & Wendy Stevens non -clinical |
Dr Murray & Sarah Bean |
Clinical Governance = Dr Sarah Eaton Complaints Leads Dr Carolyn Forrest clinical & Wendy Stevens non -clinical |
Training practice (yes/no) |
Yes |
No |
Yes |
Opening hours (list days and times) |
Monday – Friday 8am to 6pm |
Mon – Friday 8am to 12.30pm & 2pm to 6pm |
Monday – Friday 8am to 6pm |
Extended hours (list days and times) |
Monday 6.30pm to 8pm – Woolpack House Site only Saturday 8am to 12pm - Woolpack House Site only |
1 hr provided by another GP practice within our PCN |
Monday 6.30pm to 8pm – Woolpack House Site only Saturday 8am to 12pm - Woolpack House Site only |
Out of hours cover provided (list days and times) |
Yorkshire Doctors Urgent Care – Monday to Friday 6pm to 6.30pm |
GP UC telephone cover 12.30pm to 2pm. Yorkshire Doctors Urgent Care – Monday to Friday 6pm to 6.30pm |
Yorkshire Doctors Urgent Care – Monday to Friday 6pm to 6.30pm |
Enhanced services (list all enhanced services delivered) |
Special allocation Scheme Diabetes Bone Protection Service Shared Care Amber Drugs (NPT) Minor Injuries Phlebotomy Wound care and Suture Removal Complex Wound Care PSA LARC (IUS) Near Patient Testing Anticoagulation Level 4 Extended hours Improved Access Learning Disabilities Minor Surgery Public Health Vaccinations & Immunisation; Childhood imms 2yr & 5yr olds Childhood Influenza Hepatitis B ‘at risk’ Pneumococcal PCV & PPV HiB/Men C HPV MMR 10yr & 11yr olds MMR Age 16 & over Meningococcal, ACWY & B Pertussis for pregnant women Rotavirus Seasonal influenza Shingles Routine & Catch-up |
BPS; Child Imms; Child Flu; CWC; diabetes; Hep B New born; HPV girls; Men B Babies; Men ACWY; Minor injuries, Minor Surgery; MMR; Near patient Testing; Pertussis in pregnancy; Phlebotomy; Pneumo; PSA; Public Health Vacs; Rotavirus; seasonal Flu; shingles; WCSR; HibMen C |
Special allocation Scheme Diabetes Bone Protection Service Shared Care Amber Drugs (NPT) Minor Injuries Phlebotomy Wound care and Suture Removal Complex Wound Care PSA LARC (IUS) Near Patient Testing Anticoagulation Level 4 Extended hours Improved Access Learning Disabilities Minor Surgery Public Health Vaccinations & Immunisation; Childhood imms 2yr & 5yr olds Childhood Influenza Hepatitis B ‘at risk’ Pneumococcal PCV & PPV HiB/Men C HPV MMR 10yr & 11yr olds MMR Age 16 & over Meningococcal, ACWY & B Pertussis for pregnant women Rotavirus Seasonal influenza Shingles Routine & Catch-up
|
Recommendation
The Committee is
asked to note the content of this report the report
Reason: To inform Members of the proposed merger of East Parade and
the Jorvik Gillygate Medical Practices.
Annexes:
Annex 1 – Merger FAQs
Annex 2 – Mobilisation plan