Changes to Wound Service and other services from 2nd October 2024
As a Practice we receive the majority of our funding from the Government via NHS England. They in turn receive this money from you (and us) the taxpayer. We recognise how important it is that we use these funds wisely to provide the very best care that we can with the resources we have available. For context our core funding is paid under a General Medical Services (GMS) contract. This is a nationally negotiated contract used by the vast majority of GP Practices in England. This GMS contract pays us in the region of 30p per day for caring for each of you (this equates to £10 per month).
Unfortunately that funding just hasn’t increased with our costs. The same pressures we are all under for household bills apply to the Practice too. Our utility costs have increased dramatically, insurance and other costs that we cannot avoid have gone up and our staffing bill has increased (although not by as much as we feel they deserve). All of these things come from that 30p a day.
There are some additional services we supply outside of our core contract to Lincolnshire Integrated Care Board (ICB). These are known as locally enhanced services and are designed to recognise the needs of the local population. One of these is a wound care service (wound dressings, stitch, and clip removal). We have provided this service very well to thousands of patients for many years but the funding has not covered the actual costs we incur delivering that service (we receive £0.07 per patient per quarter for providing this service versus the cost of a 20 minute nurse appointment). For a long time we have accepted this loss as part of the overall package of care and we have tried our very best over the years to improve efficiencies in an attempt to continue offering this service to our patients.
Unfortunately, despite our best efforts it has become unsustainable for us to do so, as we are now losing money on every wound appointment we provide. We have received no funding for the more complicated wounds we have been managing over the years, which more often involve lengthy appointments being needed over a long period of time. These include things like cavity wounds or infected wounds.
As a result, along with other local surgeries across Southwest Lincolnshire, we have made the incredibly difficult decision to stop providing appointments for dressing services. We understand that this news will be of concern to the patients who may need to use this service in the future but due to increasing demands on our nursing team and the significant financial pressures on NHS General Practice overall, we can no longer continue to provide services that are simply not cost effective, without compromising our ability to deliver core General Practice services.
Lincolnshire ICB who commission this service, are working hard to identify who will be providing it and we expect to have more information from them over the next few weeks. We will keep you informed as soon as we have further details.
What will this mean for you? From Wednesday 2nd October 2024:
• if you come out of hospital with stitches or clips in a wound, these will be removed by another service.
• If you have a dressing on a wound that needs replacing, this will be provided by another service
• If you develop a wound, you will be signposted for an assessment with another service, who will manage any treatment
• If you have a more complex wound, including a cavity wound after surgery or an infected wound, you will be signposted to another provider
• Any wound that is from a minor injury that occurred in the last 48 hours will still be treated by our Minor Injury service here at SMG and we will then refer you to another service if further care is required
Decisions of this type are not taken lightly and we are genuinely sorry that we are unable to continue to offer this service. We have a duty to provide you with the very best care that we can and we feel that we are the right place to provide this service to patients, we are good at it and patients receive excellent care. Unfortunately we are unable to continue to provide a service that makes such a significant loss.
At the same time, we have also reviewed some of the other services we provide, and these changes will be taking place immediately –
· Routine ECGs will no longer be done at the practice, as we are not funded to provide them, and instead you will be referred to the Grantham Diagnostic Centre (old Moy Park site) for urgent ECGs and to secondary care for more routine ones - these are also the people who are best placed to then plan any additional investigations or treatment.
· 24hr ECGS will remain at the practice
· BP (blood pressure) will also be changing, and we invite blood pressure readings to be taken in our kiosk, or we will refer you under the Pharmacy First scheme. This change is more about freeing up resource to focus on delivering care to patients with more complex conditions, such as Long Term Condition Reviews (LTCs)
Thank you for your understanding, and as ever, if you have any questions, please feel free to contact me.
Debbie
Practice Manager