Allow struggling GPs to fail, NHS England official advises

A leaked letter from Paul Twomey, medical director of NHS England for North Yorkshire and Humber, has shown the official to be advising managers and GPs to let vulnerable practices ‘wither by the system’.

The document was seen by Pulse and the BBC and claims that NHS England is no longer able to ‘continue supporting practices irrespective of their ability… to transform appropriately’.

The revelation comes as media reports have suggested that £10 million of funding announced in June 2015 to support struggling GP surgeries had still not been received.

In the letter, Twomey said: “The message we need to communicate to general practice is the GP Practice Forward View must be about transformation and in that sense is not like a pilot.

“This is what we do need to explore I think in particular with the LMCs, who on the whole across Yorkshire do have a commitment and focus of quality, and appreciate that vulnerable practices must either transform and deliver a quality service or be allowed to fail and wither by the system.

“We are no longer in a position to continue supporting practices irrespective of their willingness or ability as a provider to transform appropriately.”

Responding to the letter’s content, Dr Richard Vautrey from the British Medical Association's GP committee called on the government to deliver the funding immediately.

He said: “The term transformation seems to be taking on Orwellian tones when used in this way. There are many practices who were previously performing well and valued by their patients but are now vulnerable because of spiralling workload and recruitment problems beyond their control.

“Such practices should not be written off. The whole basis of the practice resilience scheme is to provide appropriate support to practices and NHS England and CCGs should be trying to do all they can to utilise this resource.”

NHS England spokesperson said: "Rising patient demand is placing GPs under more pressure and that is why we are reversing the historic under-investment in general practice through a wide-ranging action plan, backed with half a billion pounds to support struggling practices.

"This includes a four-year, £40 million programme for helping the GP surgeries facing the most difficulties and further practical measures to stabilise general practice for the future."