GPs give up contract amid 400% service charge hike

Rachel Harmer and the three other GP partners are handing back their contract to the local NHS over spiralling costs

Doctors giving up their contract at a GP surgery over spiralling costs said another NHS organisation was "effectively making it impossible" for them to work.

East Barnwell Health Centre - serving 8,000 people in the most deprived area of Cambridge - has been left "financially unviable" by service charge rises of 400% in nine years, coupled with "inadequate" funding, Dr Rachel Harmer said.

She said they had seen an "exponential" rise in "opaque" maintenance costs from NHS Property Services (NPS).

NPS said the rises had "not constituted a material increase year-on-year and these changes have been communicated in a clear and transparent way".

The local Integrated Care Board (ICB), which oversees the NHS in the area, said it was trying to find a new provider for the GP surgery from October.

East Barnwell Health Centre has been rated "good" by the care regulator

Dr Harmer said it was "devastating" to hand back the contract, but "two significant financial challenges have rendered us financially unviable".

She said the funding formula for GP services in a deprived and younger demographic area "just doesn't work for us" and a recently promised review "didn't happen".

In addition, she said they could not afford the rise in service charges since NPS took over the building in 2015.

"There hasn't been a reason that's given. Supposedly these are market forces, but I think any layperson would be surprised that one organisation with NHS in its name is effectively making it impossible for another NHS service to be operational.

"This is a national problem and there are many GP practices that are operating out of NHS Property Services buildings, and they too are facing these same challenges."

Jade Archibald said she was worried patients with hidden disabilities would be "left behind"

Patient Jade Archibald, who is autistic, said the surgery – rated "good" by the care regulator – goes "above and beyond to support me".

The 32-year-old feared people with hidden disabilities were "going to get left behind and forgotten about, and our needs won't be met as efficiently as they are being met by the doctors and partners at the surgery".

"Because of my autism I struggle to trust people, it takes me a while to get to know people. I'd find it quite difficult to open up."

A new provider may use a "digitally-led" model, which has concerned patient Cherill Richardson.

Cherill Richardson said she could not see people using a digital service

"I'm 74 and I'm not techie. I don't know what I will do. I tried it once before, I had to send a picture, it didn't work. I can't see people doing it.

"Also in this area, we're meant to be the most deprived area [of Cambridge]… does that mean people haven't got computers, phones?"

When asked what a digitally-led model could look like, the ICB said no agreements had yet been made.

Dr Harmer said when the partners informed the local NHS of their intentions to give up the contract, they were offered an increase of £10 per patient per year of funding.

"Unfortunately that just isn't enough to meet the needs of our patients and to provide them with the care that they need and deserve.

"So you can imagine our dismay and shock when we find out a new provider is being offered £40 per patient per year more than we're currently receiving."

She feared a digitally-led model would "worsen patient access", adding: "We have to continue to raise a voice for our patients - many of them don't have a voice and we're going to continue to fight for the best quality care that they need and deserve."

The local NHS said it was looking for a new provider to take over the GP services

The Cambridgeshire and Peterborough ICB said the old and proposed contracts should not be compared like-for-like, because the new one would be fixed-term, offering greater flexibility.

It said it was committed to tackling health inequality and "any digital solutions would be developed with this at the forefront of our minds".

"We were saddened that the GP Partners at East Barnwell Health Centre have chosen to end their current contract," a statement added.

"We want to thank the team at East Barnwell for their work and reassure patients that we are in the process of finding a new provider of general practice services from October."

NPS, which is owned by the government, said it had invested in the building and upgraded facilities such as new windows and boilers.

A spokesperson said: "Cost changes have not constituted a material increase year-on-year and these changes have been communicated in a clear and transparent way, working with the practice and ICB.

"Cost increases in 22/23 were driven by an increase in utility costs, however we have since rebated some of these costs due to changes in the market, and also discussed with East Barnwell where else we can help them.

"We note the practice has cited other reasons for handing back the contract, and we are open to discuss further how we can help. We will support them, the ICB and patients to ensure services can continue to be run from the building."