THEY were once mainstays of the community along with the school, the post office and the local pub.

But the days of the GPs surgery where doctors personally know all their patients may be on the way out.

A health shake-up across Southampton could see the number of practices in the city slashed by more than two thirds to just 10, the Daily Echo can exclusively reveal.

There are currently more than 30 under the remit of the NHS Southampton City Clinical Commissioning Group (CCG), but it believed this will drop to between 10 and 20 in the next five to 10 years.

Medical professionals and politicians warn the changes, coupled with the funding and recruitment crisis could create "GP deserts" where thousands of vulnerable patients will have to travel further to visit their family doctors due to a reduction in coverage.

But health chiefs insist the plans could benefit patients by creating more "sustainable" surgeries which can offer a wider range of services such as in-house pharmacists, physiotherapists and mental health workers.

The revelation comes after the Daily Echo launched its Turn Up or Tell 'Em campaign, revealing 6,300 appointments are missed each month in Southampton alone costing the NHS £140,000 in the city alone.

The shake-up is revealed in papers prepared for the NHS Southampton City Clinical Commissioning Group which runs health services across the city.

The Primary Care Strategy for Southampton documents state: “The patient will have a choice of practices, we anticipate eventually between 10-20 practices across the city.”

The authority claims the changes will improve the service but admits there are “limited resources” and a “GP and practice nurse recruitment issue”.

A primary care worker, who wished to remain anonymous, told the Daily Echo the changes would put the welfare of thousands of patients in jeopardy and would lead to a further crisis for the GP service.

They added: “Patients are simply not aware of what is coming.

“Government cuts mean GPs are leaving to become locum doctors, going abroad or retiring, and there are none coming through to replace them.

Daily Echo:

Portswood Surgery, Belmont Road, Southampton

“Everyone who works in primary care is worried about their patients. You simply cannot provide better care for less money.

“The surgeries that merge will have to close some of their practices as this will be the only way to save money.

“This means people will have to travel further to see doctors and invariably some people will simply put off making appointments that could prove vital.”

The anonymous worker fears some surgeries, which have already lost doctors, will be handed over to businesses which they fear will only keep them going while a profit is to be made and that closures will put even more pressure on neighbouring surgeries.

Daily Echo: Southampton Test MP Alan Whitehead

Southampton Test MP Alan Whitehead (above) said the mergers are "putting a patch" on widespread problems in the NHS adding: "The danger is that we will have General Practice deserts where surgeries aren't available. There has to be a good spread so people have a reasonable opportunity to access their own doctor in reasonably close proximity."

He said more has to be done to recruit and retain doctors.

Southampton Itchen MP Royston Smith said changes are needed to help cope with an ageing population suffering from more complex forms of illness, but added: "If they are going to create a more streamlined system they need to be mindful that if people are ill speed is of the essence and it needs to be convenient for patients and people need to avoid travelling further to see a doctor."

Southampton Healthwatch chairman Harry Dymond said merging the administration of certain surgeries would be better financially by creating "economies of scale" while establishing physiotherapists and nurses at practices would help ease the pressure on individual GPs.

He said: "The whole idea of this reconfiguration is to take the load off GPs and to try and provide better care. But if it leads to closures we have to look at this very carefully because if people are sick or have young children they don't want to travel all the way across the city. But patients have to understand they may be seeing another healthcare professional such as a physio or nurse rather than a GP."

Daily Echo:

Grove Medical Practice, Grove Road, Shirley, Southampton

A GP who wished to remain anonymous said larger practices could be more "innovative" to run specialist services from healthworkers but there is a lack of "continuity" in care with doctors being less familiar with their patients.

A CCG spokeswoman said the document's figures were an "observation" based on a national trend where practices are merging to make more efficient use of resources and widening practices to include in-house services - rather than a policy driven by the authority itself CCG chairwoman Sue Robinson, herself a GP, said the forecast was a "reflection" of changes and mergers already happening among city practices.

She said: “It is not intended to suggest that the CCG has a plan to close GP practices, it is a recognition of changes practices are already making in the way they work together. We anticipate that these changes will continue over a period of five to 10 years.

“Mergers offer GP practices the opportunity to become both more sustainable and to offer patients a wider range of services.

“Furthermore, practices across the city would like to be able to offer a wider range of services to patients, such as in-house pharmacists or physiotherapists.

Daily Echo:

“It is also important to recognise that a reduction in actual GP practices will not lead to a reduction in care for patients, quite the opposite.

“Practices will ensure that there is continuity of care in seeing the same GP or nurse, for the people who find this valuable, such as people with long term conditions like diabetes and heart disease.”

The revelations come after the British Medical Association published the results of a survey, covering 3,000 surgeries, which revealed more than 900 surgeries were in a weak financial position and 294 were “unsustainable”.

It also stated 46 percent of GPs were planning to leave the NHS.

Our Turn Up or Tell 'Em campaign revealed that 6,300 slots were missed in December last year, while across the UK 61,000 appointments are missed daily.

And with each appointment costing an average of £23, the wasted time is equivalent to a year’s work for 1,300 doctors and costs the NHS £300million.

What's being proposed?

Overstretched GPs in Southampton are already planning major mergers to enable them to tackle the staffing crisis and cash shortages.

A number of surgeries have launched public consultations to join forces - which could lead to the closure of at least two branch surgeries.

GP partners are independent contractors who hold a contract with the NHS to provide general practice services.

The practices - which are also at liberty to engage with private providers to support services.

But changes must be given the go-ahead by the CCG's Primary Medical Care Commissioning Committee at meetings held in public.

Changes include:

  • Closing Newtown Health Clinic and centralising services at their main surgery at Alma Medical Centre
  • Proposals to close the Bargate Medical Centre - a branch surgery of St Mary's - at plans under public consultation.
  • Proposing merging Grove Medical Practice in Shirley with Regents Park Surgery to create Shirley Health Partnership - which is at public consultation
  • Adelaide Centre, Portswood Surgery and Nicholstown Surgery - which are run by Solent NHS Trust - are proposing to come together as one practice but all three sites will stay open. The CCG says this will "benefit" patients who will be able as they will be able to visit any of the three sites.
  • Chessel Practice in Sholing, which supported our campaign, has been managed by the private company Integrated Medical Holdings since summer 2015.

A CCG spokeswoman said mergers or closures are proposes by practices themselves and are undertaking consultation and decisions made following consideration from the authority.

She added: "We are working intensively with a number of GP practices in the city that are experiencing workload and staffing pressures. This reflects the national difficulty in recruiting and retaining both GPs and practice nurses. This means that practices are increasingly collaborating and working in partnership with others to ensure continuity of service for their patients.

"We are committed to ensuring that high quality, accessible GP services are available across Southampton and have no plans to reduce the number of GP practices in the city."