New GP service for Somerset
The NHS has just announced a restructuring of the GP service in Somerset (and beyond).
Instead of the individual surgery that has served you in the past, you will now be served by groups of surgeries.
GP practices have been “encouraged” to form themselves into Primary Care Networks which serve populations of between 30,000 and 50,000 patients.
As The Leveller reported earlier this year, Somerset faces a GP crisis. There are simply not enough. The new service structure means that most routine complaints will not be dealt with by a GP.
Dr Ed Ford, Chair of Somerset Clinical Commissioning Group, told us “The new investment in primary care networks is a welcome sign of the government’s commitment to GP services. The traditional model of GP care is changing to a more sustainable and flexible model with a broad range of practitioners working together in partnership. GP practice teams are expanding to include physiotherapists, clinical pharmacists, social prescribing link workers, nurse practitioners, physician associates as well as paramedics among others.“
The NHS insist we will still be able to access the healthcare we need. We will just be accessing it from someone who does not have the qualifications of a GP. And that may be the best use of scarce NHS resources.
Dr Ed Ford again: “What this means is that there is no longer a one size fits all approach to care. The Primary Care Networks will give our GP practices the ability to be flexible in creating multi-disciplinary teams which are tailored to respond to local needs and issues.”
You can find below all the PCNs for Somerset and who the lead GP in each PCN will be.
| Primary Care Network | Population | Clinical Director |
| West Somerset | 34,000
West Somerset Healthcare, Exmoor, Dunster and Porlock, Minehead Medical |
Dr Kelsey Boddington |
| Bridgwater | 80,000
East Quay, Taunton Road, Redgate, Somerset Bridge, Quantock, Polden, Cranleigh, Cannington, Victoria Park, North Petherton |
Dr Catherine Lewis |
| North Sedgemoor | 48,000
Axbridge, Cheddar, Highbridge, Burnham, Brent |
Dr Joey McHugh |
| West Mendip | 52,000
Glastonbury Surgery, Glastonbury Health Centre, Vine, Wells Health Centre, Wells City |
Dr Sam Rainsbury |
| Central and East Mendip | 36,000
Park, Grove, Beckington, Oakhill, Mendip Country Practice |
Dr Rob Weaver |
| Frome | 29,000
Frome Medical Centre |
Dr Rob Taylor |
| South Somerset East – Rural Practice Network | 33,000
Bruton, Milborne Port, Millbrook, Queen Camel, Wincanton |
Dr Daniel Edmonds |
| Yeovil | 58,000
Penn Hill, Ryalls Park, Preston Grove, Diamond Group, Oaklands |
Kathryn Dalby Welsh |
| South Somerset West
|
37,000
Buttercross and Ilchester, Martock and South Petherton, Crewkerne and West One, Hamdon |
Dr Berge Balian |
| Chard, Ilminster and Langport | 48,000
Langport, Essex House, Meadows, Summervale, Springmead, Tawstock, Church View |
Dr Christoph Kollmeier |
| Taunton Deane West | 28,000
Wellington, Luson, Lister |
Dr Rachel Yates |
| Taunton North /Tone Valley | 36,000
Lyngford*, North Curry, Taunton Vale, Warwick |
Dr John Edwards |
| Taunton Central | 61,000
College Way, Crown, French Weir, Quantock Vale, St James |
Dr Stuart Baker |
Perhaps the NHS should be listening to some of the comments on Facebook about the absolutely dire service now being provided by some of these primary care networks. Over an hour to answer the phone, no doctors even on duty, receptionists with no medical training deciding who you get to see, the list goes on. And it would seem these are all owned by a private company, Symphony? Privatisation by stealth. And they wonder why A & E is full.
The danger here is that no medical practitioner will actually know their patient any more. No memory of how a patient was. I suspect that very often what the patient does not say is even more important than what they do say.
This is awful news. So you wont get to see a gp anymore just a practice nurse most of the time,,, if the receptionist decides you are I’ll enough to see anyone. A and E departments will become even more clogged and more people will die, mostly older people because they don’t want to be a nuisance. The NHS is being killed off bit by bit and nobody seems to notice. 😪
So what are you all suggesting? Do you know of some magic source of fully- trained GPs just waiting to come to work in Somerset? Everyone’s an expert at what’s wrong, but I don’t see any ideas as to what to do about it! Criticising Symphony for doing their best to make the situation better (and, by the way, they are a wholly owned subsidiary of Yeovil Hospital with no private shareholders) is not going to help. We need to accept that the NHS is changing and yes, that may mean we see much more of other clinicians rather than GPs, but there are positive aspects to this as well. And ill-informed comments about untrained receptionists don’t help either! You need to join your local PPG to get the facts about the changes before sounding off!
Phil,
You seem to be the main response point for these chats, so you need to lay out exactly what is happening here before criticising comments. People are worried that the service has deteriorated beyond third world countries with comments stating what is actually happening. Symphony may be wholly owned by NHS Yeovil but they are a Private Limited company with shareholders who are GP’s, so will get dividends and bonuses if they do not spend their over £9 million budget and hence will be determined to cut costs which may mean services and resources. Please tell me if I am wrong, but best of all explain what is happening in layman’s terms for the average user of these services. That will allay peoples fears and concerns.
Kind regards
Thank you for your measured response, Tim. For the avoidance of doubt, I am the chairman of the Martock & South Petherton Patient Participation Group. Our practice is part of Symphony, but I am a patient like any other, and have no connection with Symphony other than through the PPG.
You are, indeed, incorrect in your assumptions! There are NO GP shareholders in Symphony; the entire share capital of this ‘private’ company is owned by Yeovil District Hospital. The fact that it is constituted as a private limited company is purely for administrative purposes. All GPs employed by Symphony are salaried members of staff, not partners and I am not aware that there are any dividend or bonus provisions. At the present time, the company is running at a substantial loss, due to the high costs of locum GPs.
I totally understand the distress that people are suffering as a result of the deterioration of services. As a PPG, we are doing our best to try to explain the situation and to point out what Symphony and similar organisations are doing to try to improve matters. It’s not an easy task; there is a national shortage of GPs anyway, and sadly most newly-qualified doctors are not really interested in becoming GPs and especially not working in rural areas. (One has to wonder why, but that’s another story!).
As a result, existing resources are stretched beyond reasonable limits. To try to compensate, other clinicians with specialist skills are being taken on board. Nurse practitioners, practice pharmacists, physiotherapists, health coaches and others are now taking on responsibilities that were previously handled by GPs. But this should not be seen as disadvantageous: the term ‘general practitioner’ is accurate – a GP is very good at dealing with a wide range of circumstances and conditions, but – with a few exceptions – does not profess to be expert in any. A practice pharmacist probably has a more in-depth knowledge of drugs and prescribing than a GP; a physiotherapist probably has a better understanding of musculature than a GP; a health coach is probably better placed to advise elderly or chronically-ill patients on their lifestyle choices than a GP.
In short, we should all welcome the opportunity to be seen by more appropriate clinicians for most of our minor ailments, thus freeing up our GPs for the things they are best at: spotting serious conditions and making decisions on treatment or referral. This is something that has clearly been largely accepted by Morgan Fox below and whilst I disagree with a couple of the points raised, it shows a sensible acknowledgement that things change over time, and we have to be ready to adapt to them.
The NHS has a fairly dismal record in the matter of IT systems! However, things are improving, and the new NHS App which is being rolled out at the moment offers considerable functionality and time-savings for patients. A little further down the line, systems such as AskMyGP have made great improvements in patient satisfaction with dramatic cuts in appointment waiting times in most of the practices in which it has been installed. This was really the point I was trying to make: it really doesn’t help any of us to just moan and groan about the situation. What we need to do is to find out how it is changing and grasp the opportunities for improvement that are being offered.
Sorry for such a long post, but you did ask me to explain!
All sounds very impersonal, Isn’t medicine about people, not business? Are we sure this is not ‘change for changes sake’ yet again? I will miss the continuity of seeing my GP.
Please see my reply above, Nina.
You are absolutely right in that all of us will, indeed, miss the ability to see ‘our’ GP when we want to and there is no doubt that it is very reassuring to be able to speak to someone who knows us and our medical history. But it’s not quite as bad as it seems…
In the past, notes were recorded on cards, stored away in vast filing systems within practices. This made it very difficult for any other GP to see what your situation had been in the immediate past and in such circumstances, one was constantly having to repeat the same story to different clinicians.
Now, all patient records are held electronically and instantly available to whoever is dealing with you. Your conditions, your medications, the correspondence with specialists and so on can all be called to the screen in a moment, allowing any clinician dealing with you to gain a good understanding of the situation is a short time.
No, it’s not as comforting as being able to chat to the friendly GP one has known for years, but I think we must all acknowledge that this time has passed, and we must be ready to embrace new ways of doing things.
I have now accepted that our whole world is in the process of changing completely. It is a bit frightening, but we have always had to adapt to survive. Organising ourselves to look after each other will soon become a necessity, as the medical and social care we have taken for granted disintegrates along with much of our familiar social landscape.
The writing has been on the wall for a long time. I know that our economy can’t provide perfect care for a growing number of relatively unproductive under-exercised and elderly human beings. I think that the elderly, like me, must be integrated back into the productive life of the community, somehow, I know that the schools and childcare services aren’t fit for purpose. I know we shouldn’t be selling weapons of war as part of our income. I know that our old hierarchical empire of personal wealth creation while keeping the masses quiet, exploitation of the natural world etc etc etc, is coming to an end. Chaotic change is underway and we will have to ride it out or get swept away.
I have to see the GP crisis in context with this changing world. I have a bone marrow disfunction that requires monitoring and medication to keep me alive. If I was rich it would be no problem, at least for the foreseeable future, but like most of us, I can’t afford an expensive private doctor. I am nervous about the future, but I am sure that whinging about unstoppable changes and the demise of our old, now unsustainable system won’t keep me or my loved ones alive and well.
Trying to hold back the tide never works. My mind is turning to the idea of patient groups, pooling our knowledge, experience and skills, to work out how best to use the resources we have. I feel sure there are General Doctors amongst us who would welcome such initiatives and support them. This means taking our health into our own hands, not just as individuals, but collectively. The welfare state has been a beautiful thing, but I have to accept that the state provision of services I have taken for granted is disappearing.
We are entering a new industrial revolution, of robotics, Artificial Intelligence, etc, with huge implications. I won’t see a lot of it perhaps, but what I do see is that ordinary folk will need to start planning for making provision for ourselves, because the clever, wealthy young technocrats of the future elite might have other priorities.
I cant say i agree with all the comments above but can see some problems with the new set up.
That said please can people stop saying ‘just’ a nurse practitioner! These members of staff are highly qualified and extremely able to see and assess people treating where appropriate and referring on if required. Its about the best person for the job whether that’s a nurse, therapist or another suitably trained person.
I understand there will be proper ways of assessing who needs to be seen by who and and it will be still completely possible to see a GP if really needed. its about spreading the limited resources as efficiently as possible.
If I am ill I want to see the best person for the job I really do not care whether they are a doctor or a nurse they all work alongside each other and it may be the nurse who has more knowledge in a particular area. I have always believed if you are ill you see anyone who can (hopefully) cure you saying you will wait weeks to see a particular person means you are not in severe need . I do understand that continuity of treatment is good and necessary in some treatments and am sure this new system will allow for that. I just feel lucky we can get an appointment to see a medical professional locally and free of charge (prescription fees excepted)