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Open Clinic To Close – Public Letter Posted on 16 Apr 2018

Dear Patients,

The Open Clinic service at Buckshaw Village Surgery is set to end on Friday 20th April 2018, with the surgery reverting to pre-bookable appointments for on the day problems from Monday 23rd April. 

The Open Clinic service started around 2 years ago and ran each weekday for urgent on the day issues.  The service enjoyed early success and during this time changes have been made to ensure it runs effectively but over this years’ winter period, the clinic was over-run, resulting in long waiting times and unhappy patients.  Me and my staff carried out an internal review in December 2017 and recommended a series of changes including limiting the clinic to “urgent” on the day issues.  Anybody who contacted the surgery with an issue which wasn’t covered by the Open Clinic and who couldn’t wait until the next pre-bookable appointment would receive a telephone call from the doctor the same day who could either treat them over the phone, advise of a suitable appointment or could book the patient in to the Open Clinic.  These changes came in to force at the end of January 2018.  Unfortunately the Open Clinic has continued to be very busy and the patient experience has suffered, after consultation with patients, staff and our Patient Participation Group (PPG) we have decided to close the Open Clinic and revert to on the day appointments, whilst at the same time increasing the number of pre-bookable appointments.

Buckshaw Village Surgery has a different type of contract to nearly all other GP surgeries; an APMS contract and  until 2016, this contract specified the surgery had to offer 82 GP Appointments per 1,000 patients.  However when the contract was renewed in October 2016 core funding was reduced by approximately 23% and simultaneously the number of appointments that had to be offered was reduced to 70 Clinical Appointments per weighted 1,000 patients.  This change of funding and reduction in the number of appointments was set by the local Clinical Commissioning Group (CCG) when they commissioned the new contract and would have been exactly the same, regardless of who won the competitive tendering process. 

Weighted patient list is a national formula which has been in use since 2004 and takes into consideration, along with other practice characteristics, individual patients' age, gender and health conditions and calculates a "weighted" count of patients according to need. This means that two practices with the same number of patients may have very different weighted patient numbers due to widely varying patient characteristics and health conditions, and as a result, these practices which may seem to be similar in terms of list size, could receive very different levels of funding.  At Buckshaw Village Surgery our weighted list is approximately 15% lower than the actual number of patients registered at the surgery.

The difference between GP and Clinical appointments is GP appointments must be with a GP however a clinical appointment is any appointment with an independent prescribing Clinician which includes doctors as well as Nurse Clinicians, Nurse Practitioners or prescribing Pharmacists. 

The surgery has always offered late night opening on a Monday and always volunteered to open at weekends, when funding was provided.  In September 2017 the Weekend Opening Service was withdrawn and this led to a loss of an additional 72 appointments a week.  The surgery is continuing to explore ways it can re-open at weekends as these clinics have proved popular with patients, however it is my belief any service must be properly funded.

These changes, which the surgery have little control over, have led to proportionally fewer appointments being available at the surgery and whilst striving to offer a good level of access, the current system struggled to cope, especially over the winter months.  On behalf of the surgery I would like to apologise for this problem and for the inconvenience this has caused.  I can assure you the surgery has now completed a full review and has decided to, reluctantly, close the Open Clinic and transition back to a pre-bookable system, which will free up more pre-bookable appointments for patients to use.  The final day of the Open Clinic will be Friday 20th April 2018; from Monday 23rd April we are asking patients to book on the day appointments via Patient Access, in person or via the telephone.  These appointments will be released each morning on Patient Access at 7am, with the surgery and telephone lines opening from 8am.

Yours faithfully,

Craig Lee

Practice Manager
Buckshaw Village Surgery

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Buckshaw Village Health Centre, Unity Place, Buckshaw Village, Chorley, PR7 7HZ
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