Luson Surgery

• Despite the best efforts of the team at Luson Surgery and NHS Somserset, there have been ongoing resilience and sustainability challenges faced by the practice over the last 12-18 months. This is largely due to GP staffing and premises challenges, ultimately impacting on the financial sustainability of the practice.
• General practices are normally independent businesses owned by the practice partners and in this case, having taken all the relevant advice from specialists, the partners came to the difficult decision to resign their contract, which is sometimes known as a contract handback.
• As commissioner of general practice in the county, NHS Somerset considered the options available to ensure all patients of the practice had continuing access to GP care, in line with ICB legal responsibilities.
• Retendering (seeing if anyone wanted to take on the practice business) the practice contract was considered, but a relatively small list size of 6,600 and ongoing challenges with the outdated premises meant the proposition was unlikely to have been attractive to prospective operators. With a low chance of attracting viable bidders, NHS Somerset was unlikely to gain approval to retender the contract. Moreover, these days, due to the extensive range of services offered by GP practices, larger practices are generally viewed as more sustainable.

Safely moving patients to Wellington Medical Centre

• Wellington Medical Centre, a large and well-run practice a short distance from Luson Surgery, was the chosen for what the NHS calls a ‘list dispersal’. In practice in this case, this means automatically moving the vast majority of Luson’s patients to Wellington Medical Centre, with no action required by patients
• Luson is closing on Friday 26 September and its patient list is being moved to Wellington Medical Centre from Monday 29 September.
• Extensive planning between both practices, NHS Somerset and other local partners – including care homes and community services – has been undertaken to make the change as seamless as possible.
• The contract notice period was six months, but local partners have worked together to make the change happen faster so that the closure didn’t occur in the peak winter period, when there is the highest demand on NHS services.

More staff at Wellington Medical Centre to care for the additional patients

• At roughly 23,000 people, Wellington Medical Centre’s new list size will be about 40% larger, made up of its current list of approximately 16,500 and the Luson list of about 6,500.
• Accordingly, the practice is increasing its clinical staffing – mainly doctors and nurses – to enable the team to continue to provide a good service to patients.
• The practice is pleased to confirm that it has successfully recruited five more doctors, amounting to an additional 30 ‘sessions’ per week – approximately 3.4 Full Time Equivalent (FTE) posts. Under nationally agreed rules, a session is just over half a day – 4 hours 10 minutes.
• The practice is pleased to confirm that Luson’s GP partners – Dr Rachel Yates and Dr Adedayo Awodiji – will be joining the Wellington Medical Centre as salaried GPs. Attempts will be made to allow their current patients at Luson to continue to see them at WMC but this will not be possible in all cases.

Strong performance at Wellington Medical Centre

NHS Somerset considers Wellington Medical Centre to be a high performing practice with good standards of patient care and quality.

As an indicator of performance:

• From 8-14 September, the practice provided a total of 1,673 appointments with clinicians – an average of about 334 every day.
• In that week there were 47 ‘Did Not Attends’ – when a patient does not turn up for a booked appointment. The practice follows these issues up with patients.
• The national average for number of appointments per 1,000 head of population per week is 70. That figure for Wellington Medical Centre is significantly higher, at 103 per week.
• The average waiting time for a routine (non-urgent) appointment at Wellington Medical Centre is about 2.5 weeks. The average waiting time for an urgent appointment is 1.67 days.
• The triage system used by the practice means that a doctor reviews all incoming requests for an appointment to decide whether an urgent or routine appointment is needed.

Luson Employees

Luson and WMC have complied with all of their respective legal obligations with regards to the affected employees.

Capital funding for expanding GP services in Wellington

• NHS Somerset took over the responsibility for commissioning primary care services from NHS England in 2019. Since then, we have been working in partnership with an agency to review housing development applications (those made up of more than 20 dwellings) to assess whether they may have an impact on the infrastructure capacity at local GP practices. Where developments are considered to have such an impact, NHS Somerset submits a Section 106 application to the Council for consideration.
• Prior to the announcement made by the Luson Surgery to close their practice, NHS Somerset would have taken into consideration patient capacity at both Luson Surgery and Wellington Medical practices facilities when considering housing development applications and the impact that these may pose.
• Following the decision by Luson, NHS Somerset has reevaluated planning applications not yet decided to understand additional impact on the Wellington Medical Practice, and where appropriate, an adjustment will be made to the s106 applications we have submitted.
• Any capital funding awarded to NHS Somerset as a result of the s106 applications will, along with any additional resource available, be considered appropriately and a decision made on how this is best used to mitigate the impact of the housing developments within the locality.
• NHS Somerset’s current intentions would be to use any local S106 funding to support expansion or development of Wellington Medical Centre premises and services. Large practices are seen as more sustainable than smaller ones and it can be difficult to attract providers to start new practices.
• WMC and NHS Somerset are currently considering whether it would be feasible to convert the former (Boots) pharmacy at WMC into more clinical space to help accommodate the additional patients from Luson.

There is very limited NHS capital funding available nationally for funding GP premises developments and use of any funding that becomes available is carefully prioritised by local health systems.