OUR FUTURE AND HOW TO WE ARE
IMPROVING SERVICES TO PATIENTS
For many years we have sought to improve our ability to
widen the healthcare services we can offer to our patients
- be they newborn right through to our most senior patients.
Below is the progress of our journey
to relocate both Willerby Surgery and Swanland Surgery
into new, modern, purpose built premises.
21 May 2022 We are now in our third week at our new surgery : the address is
Willand Primary Care Centre, Lowfield Road, Anlaby. HU10 7JR
Our telephone number remains the same (01482 652652) and we are still Willerby & Swanland Surgery.
As our journey to our new premises is now complete, this is the last update we are publishing on this page.
We have most of the new furnishings and equipment received, we are settling in to the new environment and we are testing the new systems to provide better responses.
There remains a lot to learn about how we manage the new building - as well as bringing in improvements to what we do and what new services we can provide for our patients - that is, in itself, a challenge to us and we will update relevant webpages as we introduce any changes.
As it stands, expectations on us to deliver better access are high : but we are still the same size team today as we were three weeks ago so we need time to grow our team in line with services offered. It is what we all want to do and we hope you will understand that, like the move itself, we are on a journey to improve : it is an evolution not a revolution. We are on it..................
09 May 2022 The great news today was the delivery of our new examination couches - well most of them - so our clinicians were very relieved !
Some of the issues that we need to sort out as soon as possible - the lift management program needs to be updated to 'disable' the staff-only floor so patients do not inadvertently end up on the wrong floor and the door closing mechanism needs to be reviewed so that they close after arriving at each floor (they have decided to stay open until called, which is not helpful). We expect the lift engineers on site tomorrow morning at 7.30am so this will get fixed as a priority
We have not been able to fully program the new patient call system which means the clinicians will have to call patients one at a time from the waiting areas - hopefully this will be remedied during Tuesday. However, the self-check in screens work brilliantly so that should reduce queuing at Reception.
The covid screen at Reception has not been installed - there are some issues creating the curved section for the desk. Patients still need to wear face masks so we hope this will not be a major cause of concern for patients or staff. It will be installed later this week.
We are still missing some additional sign-posting both inside and outside the building. Staff will be on hand to help direct patients to relevant areas of the new surgery.
Pretty much all the consulting rooms have been checked and equipped and are ready to receive patients. There will still need to be quite a lot of cupboards to be properly sorted but everyone has worked hard today to ensure they have everything available to treat our patients.
Staff have been issued with door fobs so they can get in to all their work areas - some adjustments need to be made to the locks on the ground floor staff-only areas but we will be mindful that patients might inadvertently use wrong doors so additional staff are on hand to guide people.
We are still awaiting some additional waiting area chairs, some tables for meeting rooms and the new interview room and we have started to list office items that we need to get extras of to assist the support functions. At the same time we need to exchange some faulty computer equipment and increase data points in some offices - for the time being will need to 'hot desk' staff.
The new telephones are installed, tested and working and this will be one area where we look to make substantial improvements to the patient experience over the coming weeks.
Tomorrow (Tuesday10th May) we open to patients - thank you for your help in the last couple of days by keeping your requests down to urgent-only. It is really appreciated and, whilst is may mean we have a bit of a back-log of appointments requests for a few days, we have additional GP and Nurse appointments.
WE ARE NOW OPEN - welcome to our new surgery.........
07 May 2022 So we finally moved out of Willerby premises and in to our new surgery on Friday - and what a day that proved to be.
Firstly, however - a thank you : to all our patients who have been able to defer requests to us which are able to wait until Tuesday 10th onwards - leaving the restricted service available for patients with urgent medical needs.
Please bear with us for one more day on Monday 9th : we have created a system to enable us to answer urgent medical requests for GP contact but we will continue to only have limited access to the records until our IT team start connecting and commissioning the computers.
Friday was a day of excitement and energy with last minute work on the most urgent snagging to ensure we are able to open safely on Tuesday 10th.
Unfortunately some things will not be completed on time : including the extra signage we have asked for. We still await delivery of some medical equipment and furnishings. We did, however, ensure we got as much ready as possible (not least putting hand wash and towels in all the 11 toilets!!).
Much of the boxes we moved across from Willerby are still to be emptied and sorted but we have aimed to get as much done as needed so we can see our first patient on Tuesday morning.
Monday will see the main building management handover to us and that will then be accompanied by staff training so we can direct patients, manage security and safely offer access to our services.
Additionally we expect to receive the new medical examination couches, some extra furnishings (including office tables and chairs !!) and we will liven our new telephone system. That will also take time to train our staff on since the handsets are quite different as is the whole basis of the telephone system : effectively it is a web-based system which should mean we can very quickly improve patient experience with call back, queue management and directed options.
We are nearly there with the essentials and that means Monday will complete the transition phase - we look forward to Tuesday when we can start to benefit from a brand new, purpose built building that will be out home for years to come.
05 May 2022 Just a reminder to all our patients : tomorrow - Friday 6 May - and Monday 9 May our premises are closed to patients during our relocation. We have restricted capacity during these days and will not be able to host face-to-face appointments. If you urgently need to contact us before Tuesday 10 May please telephone us and listen to the updated messages for instructions - see our 'When we are Closed' page for more information.
Please be aware : you cannot access the new premises until Tuesday 10 May - we are on site and staff and contractors will be in and out - but it is not yet open to the public.
Whilst it is nice that people come and look - please be aware that this is still a building site so we cannot admit any patients - even to drop off prescription requests etc - until we open on Tuesday 10 May.
Fire alarms were tested today and a few issues became apparent that need to be addressed before we open - nothing major but rather areas that haven't worked as expected. Parallel to the alarm testing was an update on the atmosphere control system which is a mix of outside air mixed with internal conditioned air to achieve a stable, fresh feel and temperature control.
As well as the continuous cycle of cleaning and washing to clear dust etc we have received and installed consumables in the rest rooms etc (no small task in these premises since we now have 11 toilets, 25 hand/wash basins all requiring handwash and towels, some needing antiseptic hand gel, some electric hand dryers and so on.....)
Contractors are putting the final touches to new systems and IT engineers are checking connectivity and making adjustments to new computers, printers, photocopiers and so forth.
Whilst most of the heavy, visible work is completed the amount of background detail that is needed to get systems to work is, in some ways, daunting. But - we are making excellent progress and the building is ready to receive of transferred furnishings etc etc from the Main Street premises tomorrow (Friday)
As the equipment is boxed up and transported across, staff teams will follow and begin the task of orientating themselves to the new premises. We have now just a matter of hours before we are ready to welcome our patients to our new surgery.
Here is a selection of actual photos from the new surgery (if you click to enlarge you will see a brief description of each photograph:
04 May 2022 Today we linked the new patient call screens to the self check-in : testing this was not straightforward because all our clinicians are still at Willerby premises. However we managed a dummy run and now need to wait until relocate day (Friday)
A new staff and visitor sign-in system has been installed which should take away non-patient tasks from our reception, meaning we can focus more quickly on helping patients.
New waiting area chairs have been received and positioned - although we still have more to come (production delays are affecting these too!!)
The new interview room has been fitted out so we can improve privacy and confidentiality more readily. Some additional computer infrastructure still needs to go in and this is expected by end of week - and we are also now in the process of fitting the baby change room and getting suitable chairs for the baby feed room.
A lot of snagging remains - some of which we really are pressing the contractors to complete before Tuesday 10th May. New signage is also awaited to help staff and patients alike navigate the new premises. Safety equipment has been placed appropriately and we have installed a hearing loop at reception.
We have been advised of further delays to some of the new consulting room equipment - but we have been assured that the new examination couches will be received on Monday. That will mean a last minute rush to install them and calibrate them ready for use on the Tuesday.
Tomorrow (Thursday) will see a substantial training/orientation session on the building management systems : everything from how to operate all the various lights to how to handle the new telephone system to managing the air conditioning so we neither cook nor freeze ourselves and our patients - hopefully we get to finally use the hot water boiler to make a pot of tea !
There is what seems like an unending list of things to do, sort out, put in place, find, commission, get delivery of etc etc before Friday when we will be closed to patients to enable us to decommission everything at Willerby and bring it across to Anlaby to be recommissioned, fitted and tested.
Because we will not have any clinicial system or telephone system we will be closed to patients from Friday 6 May until Tuesday 10 May. However, we have put in place a system for urgent medical needs and this is detailed on our 'When we are Closed' page.
Tomorrow we will update this page with some pictures of what the building actually looks like rather than the ones below which are artistic impressions.
02 May 2022 Good progress across the building - and all over the weekend there has been decorating and snagging taking place to ensure the consulting rooms and patient areas are cleaned and ready to receive new equiment.
We have installed and tested the new self-check in screens and on Tuesday we expect to have the new call screens installed. That will mean patients can avoid queuing at the reception desk to book themselves in for their appointment - and there is a check-in point on both the ground and first floor. Regardless of where your appointment is you can use either point : patients will be directed to either the ground or first floor waiting areas.
We are awaiting new seating for the waiting areas - and we have a delay on the new examinatuon couches, although we expect these to still be with us in time for next Tuesday opening.
We are also still reviewing the signage and have asked for revisions/additions to help patients (and staff !!) navigate the new premises.
After our fire safety training we have ahead of us a full set of training on the building management systems to ensure we can understand the array of new installations - but this is not liekly to impact on our patients.
Tuesday (3 May) is also going to be a very busy time as coordinating the ongoing snagging, deliveries and computer installations gets underway in ernest - as does the new telephone system installation.
We would like to remind patients that, whilst we will be open on Tuesday 10 May at the new premises we will be working at reduced capacity as we all orientate ourselves in the new premises. You can help us enormously by considering whether you can delay requests for appointments for a few days. That will mean we can more quickly get up to speed to see more of you for longer
28 April 2022 Work continues to the detail now - for example getting the exterior building sign placements agreed and the the lighting installed. Deliveries are being received regularly with new equipment and the key install today was the new patient self-check in screens.
These are part of the improvements we have been waiting to offer our patients because using these will significantly improve the time patients have to spend at reception just to check-in for their appointments. The new system is very intuitive to use and we have placed one on the ground floor and one on the first floor. It does not matter which floor patient's need to attend for their appointment they can use either screen to check in, be guided which waiting area to be in and the system will record them as arriving for their appointment.
Tomorrow we are holding additional training for our staff teams on building safety, receiving additional IT equipment and continuing with snagging tasks alongside the contractors. So far the only key issue we are concerned about is the delivery of waiting area chairs and clinical rooms examination couches. More updates will be posted as the week progresses.
27 April 2022 After two very full and busy days since Monday 25th we are pleased that we have now received the contractors "Certificate of Practical Completion" That means we are now in possession of the building and we have been able to start receiving deliveries of new medical equipment, furnishings and IT.
Yesterday we had our first staff training on fire safety - with additional training organised for the end of this week - and today we have been installing all the additional hygiene equipment and fitting out the consulting rooms with extra computers and such like.
We have received our new patient self-check in screens and these are being commissioned later this week ready for our first day of opening, which will be Tuesday 10 May.
New chairs for the waiting areas are expected to be with us early next week; although we know some have been held up due to supply disruption but we will utilise our existing chairs so we have enough seating in both wating areas.
We have started to furnish the new patient interview room so that this can be readied to support patients without good internet connectivity to access video consulttations with hospital consultants etc. and we have spent a lot of time with the signage consultants to ensure we have clear, unambiguos directions for everybody to safely navigate the new building.
There is a lot to do in a relavtively short time - snagging lists have been drawn up and the contractor is working hard with the relevant trades people to get these done over the next few days. We have also planned the relocation of existing equipment from Willerby Main Street and we have agreed with the CCG that we will be closed on Friday 6 May and Monday 9 May (out-of-hours cover has been arranged by the CCG) so that all personal computing equipment and medical equipment will be transferred out of Willerby and into the new Willand premises over that weekend.
22 April 2022 Today we had a full site visit to check progress on the building so that we could anticipate and manage problems or issues that need to be resolved in time for our expected practical completion on Monday 25 April.
That is the date we hope to have the keys to our new surgery and we can start to transfer equipment etc in readiness for opening to patients on Tuesday 10 May 2022.
There are some outstanding items but it was great to note how far the progress has come on - and we believe we will be able to achieve completion on Monday : keep a check here as we will update you with a daily countdown from then on until our opening date on 10 May 2022.
REMEMBER: We have been using mobile phone SMS for many, many months now to enable online consultations and announcements. Please ensure we have your correct mobile phone number
01 March 2022 We have had the best update on our new premises relocation date - which is now planned for 10 May 2022. From that date we will be offering our patient appointments at the new Willand Primary Care Centre in Lowfield Road, Anlaby.
There is still a degree of uncertainty but we are now planning and arranging for our move over the weekend of 7/8/9 May. It may be that on Friday 6th and Monday 9th May we are not open for any patients but rather will put in place Out of Hours cover for urgent medical needs.
Our reception team will tell you in the lead up to move date where to attend for appointments from mid May onwards.
February 2022 Whilst we are disappointed with the delayed completion date for our new surgery premises we realise that a project of this size will always be subject to things beyond our control. We can, however, confirm we have made great progress with the design and shape of the internal areas and share here some artist impressions of what our patients might experience as they transition across to the new building - target remains mid to end April 2022
February 2022 At our last site meeting we were disappointed to learn that the completion date for the new premises has been put back further to mid April 2022
This delay is beyond our control : with the current problem relating to getting gas supply into the building.
However - good progress is made on many other areas including telephony, room layouts, equipment provision, furnishings and room finishings.
Below is an internal plan for the three floors of our new premises: this is to give a sense of scale to the project and share our vision of offering increased access to primary care treatments which we cannot provide currently (multi-therapists, specialist nurses, mental health as well as health education backing up your GP treatments.
January 2022 Having seen our branch in Swanland close, we have been able to offer extra nurse appointments at Willerby - and we have been able to restore pretty much all requests for face-2-face GP appointments (subject as ever to availability). At the present we are trying to re-enable online booking but our clinical system provider (EmisWeb) is not yet enabled.
We are trialling a new appointments rota to offer more opportunity for patients to book up to 5 days ahead for an appointment across all our GP team - a system we will continue in our new premises. Regrettably we cannot make our telephone system more efficient until the move - so please bear with us - but we are aiming to do away with the need for patients to call back during the day by making all appointment times open to book at the point a patient rings us.
Swanland branch has closed permanently from w/ending 04 December 2021
November 2021 We have now an agreed date for our branch at Swanland to close prior to our relocation to brand new premises in January 2022. Unfortunately we need to close the Swanland branch ahead of relocation to the new building in order that the IT and medical equipment etc can be updated/tested and installed in the new building well ahead of occupation so we can be confident and assured everything is operational from day one of the move.
In the interim period between the branch closing and the new premises opening we will manage all appointments and all patient queries at Willerby Surgery - pretty much as we do now for most of the week.
To request appointments - we are open at Willerby Surgery each day, Monday to Friday, tel 01482 652652
To request prescriptions - patients can continue, as now, to order online (for more details about registering for online access please click here) or repeat slips can be handed or posted to Willerby Surgery. 45 Main Street, Willerby HU10 6BP until we relocate to the new building.
To request home visits - telephone 01482 652652 and select the relevant option
Please be aware : you do not need to find another doctor - you will remain a patient of Willerby & Swanland Surgery.
We are sorry this temporary change to Willerby Surgery is necessary until our new building is ready - however it will ensure the smooth transition of staff, equipment and patient services which will ultimately mean we can provide you with the best possible service and experience in fit-for-purpose premises with better access and better facilities than we could ever hope to provide in out-dated buildings with no chance of improvement.
We are already increasing our clinical team and upskilling our support team.
With our new premises comes a new telephone system which will help take away many of the frustrations you face now with engaged tones, long answer times etc - and as we get settled in to the new premises we are planning to offer many new services that simply are not possible at the moment due to current poor quality spaces we operates from.
This is a great investment in our patient services : we realise there has been some disruption over the last few months - not helped in anyway by the pandemic - and apologise for inconveniencing patients : even though we have tried very hard to keep this to a minimum we know we have not always delivered what we want to.
We hope that, like us, you find this transition period not too difficult and the new premises very much brings us back to delivering the highest standard of care you expect and deserve
May 2021 We have reluctantly accepted the resignation from mid-August from Dr Wendy Hart who, for many years, has been a mainstay doctor at our Swanland branch. We wish Dr Hart the very best for her future.
Due to the end of the lease for Swanland Practice mid-October 2021, We have applied to East Riding of Yorkshire CCG for an interim closure of Swanland branch ahead of the final closure when relocation happens in January 2022.
Effective from end of November 2021, this will mean patients who might normally attend at Swanland will have their care transferred to Willerby Surgery until the final relocation anticipated for January 2022 - approximately 20 weeks.
We already provide most nurse and GP appointments from Willerby Surgery and we will increase our provision to ensure we accommodate those patients currently seen at our Swanland branch - and in particular we will work with patients who need to use public transport to provide flexibility of appointment times to mirror bus arrival/departure.
April 2021 The East Riding of Yorkshire Council has confirmed the new premises registered address - including postcode - and we are delighted to be able to show an updated artist impression for our new building.
The building will be named Willand Primary Care Centre and the address is Lowfield Road, Anlaby. HU10 7JR. We will retain our current name - Willerby & Swanland Surgery - and our telephone number will be the same as now.
Willerby & Swanland Surgery. Willand Primary Care Centre. Lowfield Road, Anlaby. HU10 7JR
Below is the site plan indicating how the new premises sits within the development on Lowfield Road
This location map shows the new premises in relation to our existing locations at Swanland and Willerby :
February 2021 The developer has confirmed that a building contractor - Hobson & Porter - has been successful in tendering and has been awarded the contract to build our new surgery. Work is expected to begin on site in March 2021 with a handover date of 14 January 2022.
December 2020 We have made arrangements for disposal of our current premises, we have started to look in detail at the specifications for room data in the new premises, we have begun to pull together the strategic partners who we will work with the ensure IT / telecoms and design are incorporated in our new premises. We are awaiting the appointment of a building contractor
October 2020 Having resubmitted our final business case to the East Riding CCG the plans were discussed and approved at an open meeting of the full Board. The CCG has confirmed this to us in writing so we are now getting plans in place to make this relocation a reality.
It has been confirmed by the CCG that the new premises are for the co-location of both Willerby Surgery and Swanland Surgery premises
11/05/20 We are resubmitting our final business case to the East Riding CCG with updated information and hope this will be ratified before the end of June so that we can begin the development.
31/12/19 As we start the new year and decade we are still awaiting final planning approval for the new building. All the relevant stages bar this have been completed so the practice and the developer are hopeful that an early decision in 2020 will see an actual start of the building - with an occupation date late 2020/early 2021.
05/04/19 The developer for the proposed new premises has submitted a revised planning application to East Riding of Yorkshire Council to change the building structure from a two storey to a three storey build.
This will ensure future capacity is built in from day one and will secure for Haltemprice residents the only significant health investment since Beverley Community Hospital was opened. You can view and comment on these revised plans by visiting the ERYC website https://newplanningaccess.eastriding.gov.uk/newplanningaccess/applicationDetails.do?activeTab=summary&keyVal=POCYNCBJI5N00
05/03/19 - We are now moving forward with discussions and plans to work with Humber Wolds Rural Action Charity (HWRAC) in developing a volunteer transport scheme to support any patient who needs to get to an appointment with the doctor - or indeed and healthcare appointment and - if possible - widen this to include transport for social needs such as shopping etc.
Our planned meeting is on Tuesday 19 March and will be held at Willerby Surgery at 09.30am. Although not intended to be an open meeting at this stage, we will be asking any interested patient - and our Patient Group - to work with us to start to build a database of interested people who are happy to join as volunteer drivers.
This will be a really great opportunity which we want to start as soon as possible so that if we finally conclude a move to new premises we have a working scheme up and running.
31/12/18 UPDATE announcement from East Riding of Yorkshire CCG
"New East Riding medical centre moves a step closer
Plans to develop a brand new medical centre in East Riding of Yorkshire have moved a step forward this week, after an outline business case and additional supporting information put forward by the Willerby and Swanland GP practice was discussed and approved to progress by the NHS East Riding of Yorkshire Clinical Commissioning Group (CCG) Governing Body.
The GP practice has been working with a local developer to consider options and create plans for developing a new medical centre on Lowfield Road, Anlaby. The development would enable the practice to attract and retain vital skilled staff to the area (including GPs), enable collaborative working between the practice and community nursing teams and mental health teams in expanded premises, provide extended access with appointments available at weekends and later into the evening and secure high quality and safe GP services locally in purpose built and modern facilities.
Jane Hawkard, Chief Officer for NHS East Riding of Yorkshire CCG said:
“Our Governing Body has carefully weighed up the GP practice’s case for change and listened to the views put forward from the local community. The Governing Body agrees that, based on the evidence presented, there is a need for this practice development in order to continue to provide and sustain essential primary care services into the future. The development will also provide GP services to support people moving into the extra housing developments expected within the next 5 years.
“We would like to thank those who engaged with us and the practice regarding this proposal. We have taken seriously all the comments raised and asked the practice to provide assurances about how they intend to minimise impact on their patients, which they have done.
“We understand that a relocation may have an impact on patients travelling to appointments, particularly elderly patients. The practice confirms that they have analysed this impact through a patient survey they conducted in December 2017 and January 2018 and are working with Humber and Wolds Rural Action to improve the offer to their patients in terms of assistance with transport for appointments if needed. The Governing Body also recognised that both Willerby and Swanland have very high rates of car ownership.
“Local people also asked whether alternative sites had been looked into and the practice has provided evidence that known current alternative and available sites have been explored and considered.”
The development will now be subject to local authority planning permission and final approval by the CCG of a full business case within the identified financial envelope, expected in March 2019. Should all of this be met, the development will result in a modern and fit for purpose build by November 2020, that will ensure that GP services are sustainable as demand and population continues to grow. The proposed new centre would see patients relocate from both its existing surgeries, in Willerby and Swanland, to the new site and allow the practice to initially increase its patient capacity from 8,600 to 11,250.
The practice will continue to work with their patients through the development phase and beyond to deliver high quality GP services and ensure that patient needs are met appropriately."
Comment from the practice :
We recognise that we have some work to do to ensure, where possible, that we understand the needs of patients who might be disadvantaged by a relocation of premises - in particular, those patients who have no means of transport of their own or from family/friends. This will be a significant piece of work to build on what has already been undertaken and more details will be published early in the new year.
06/09/18 UPDATE - We continue to progress the urgent need for a solution to our premises problems with East Riding of Yorkshire CCG and NHS England. The ability for us to continue to provide primary care services to existing and new patients is a growing challenge in both financial and capacity.
There is no change to our preference for relocation to new premises (as detailed fully below).
28 JUNE 2018 - PUBLISHED FEEDBACK NOW AVAILABLE (to download this document click here)
This is our Feedback Response to the comments received during the public engagement on our premises proposals. The engagement consisted of two public meetings held 11 April at Willerby and 12 April at Swanland – followed by a collection period throughout April for written and electronic comments from patients until first week of May 2018.
Additionally, letters were received from ward and parish councillors with collected feedback and observational comments and we received feedback from the East Riding of Yorkshire Council Health, Care and Wellbeing Overview and Scrutiny Sub-Committee.
We have reviewed all the comments received and this document details our response.
We published numbers and graphs earlier this month showing the number of comments and the main issues identified by our patients (see below). The feedback is intended to address each of these issues with the outcome from our review.
Letters were received from North Ferriby Parish Council, Swanland Parish Council and five East Riding of Yorkshire Council ward councillors. The East Riding of Yorkshire Council OSC did not support the option for relocation without the presence of any other viable options and asked that we contact the Council’s Forward Planning and Housing Strategy Manager to discuss other options. Additionally we were asked to consider reopening the consultation and presenting more than one viable option
SUMMARY OF FEEDBACK FROM CONSULTATIONS
Willerby & Swanland Surgery held two public meetings and were open to receive feedback comments throughout April 2018.
In total, 295 attended the public meetings (110 at Swanland and 185 at Willerby)
126 people did not offer any comments at the meetings
169 people offered feedback/wrote comments and further feedback was received during April from 21 people (8 emails / 13 written)
Letters were received from North Ferriby Parish Council, Swanland Parish Council and five East Riding of Yorkshire Council ward councillors.
Although we closed the feedback window at the beginning of May we subsequently received a further 4 emails and 1 written comment and we have included these in the statistics:
SUMMARY OF FEEDBACK HEALTH, CARE and WELLBEING OVERVIEW and SCRUTINY SUB-COMMITTEE (OSC)
The East Riding of Yorkshire Council OSC did not support the option for relocation without the presence of any other viable options and asked that we contact the Council’s Forward Planning and Housing Strategy Manager to discuss other options. Additionally we were asked to consider reopening the consultation and presenting more than one viable option.
RESPONSE TO THE FEEDBACK COMMENTS
The greatest number of comments received (139) were about the proposed location.
The five main elements commented on were
Relocate in Willerby
Relocate in Swanland
Retain and improve current premises in Willerby
Retain the current premises in Swanland
Why the proposed site at Anlaby
Relocate in Willerby: Conclusion. At the time of agreeing to work with the site developer, Lovel Development, we had unsuccessfully sought to identify and acquire any site within Willerby capable of supporting the minimum ¾ acre site needed for any new premises. In 2016 we reached a provisional agreement with the developer that subject to planning permission and financial support being secured from NHSE/ERYCCG we would develop a long-term business case to relocate to the development in Anlaby.
We have not identified any suggested locations to develop within Willerby which we have not previously, unsuccessfully, pursued or which are deliverable in a realistic timescale. We have, nonetheless, reviewed all previous proposals and any possibilities available in the ERYCouncil Local Plan but have not found any which are available, affordable and deliverable.
The proposed location is currently the only one available to us that meets those three essential criteria.
We believe delay in pursuing this proposal will lose the support of the developer and leave the practice with no medium or long-term alternative. The outline business case stated completion of any new building would be by Spring 2020, meaning construction will need to start early 2019. Undue delay is highly likely to be detrimental to the community, jeopardizing the ongoing viability of the practice and providing no ability to absorb new patients across the practice boundary.
Since early 2008 we have sought suitable areas within Willerby to host new surgery premises that would be cost effective, future proof and within the financial envelope that the health authority would support.
Our first business case demonstrated the strategic need for redevelopment – with the condition that new premises development would involve working at scale and include a second, local practice.
The land we pursued at that time (now the site of Aldi Supermarket) was not within an affordable cost window we were unable to proceed.
Following that first attempt in 2008 to secure land we have continued to identify locations and engaged with (the then) local parish councillors, East Riding of Yorkshire Council (ERYCouncil) planners, East Riding of Yorkshire PCT(ERYPCT), local land owner/businessman, local estate agents, private developers and shopping park owners.
As early as 2010 we asked ERYCouncil what land could be identified for development and an early draft of the current housing plan showed several areas ear-marked for development.
With our then development partners, GPI, over the next three years we made approaches to acquire land in an exhaustive number of locations, including Well Lane, Grange Park Lane adjacent to Health House, land now occupied by Lidl Supermarket, current St Georges Square housing land, undeveloped land in The Parkway, land at the top of Main Street, land adjacent to the Mercure Hotel (at the time, the Ramada Jarvis), the housing development land now being constructed off Beverley Road, land behind Willerby Square public car park, land owned by Yorkshire Water in Black Lane and a number of private business and house owners. We also had dialogue with the other occupiers on the land beside our existing Willerby premises (the youth organization, social club and woodwork factory owner) to rebuild the surgery at the rear of our current location.
None of these approaches have been successful – in many instances we were unable to engage in meaningful dialogue, in other instances the land acquisition costs were so high that we could not make a financial business case or the proposed site was not large enough for a new surgery (needing a minimum area of ¾ acre).
In 2010 we were able to identify a development opportunity in Chestnut Avenue and submitted a revised business case which was well received by the ERYPCT but which was delayed due to a nesting colony of bats. By the time this colony was able to be relocated in mid 2011, the ERYPCT was unable to support any capital expenditure and the subsequent delay resulted in the loss of the site.
We continued to seek development opportunities, including revisiting many of sites above which were large enough to support new premises and which had been either declined to us without success. One of the two partner practices who would have relocated with us gained their own new premises and the second practice withdrew.
In 2013, we re-examined the possibility of developing our existing premises with our development partner, GPI, and created a business case for this. Whilst this would have addressed the immediate need for better facilities, the extra clinical space could not demonstrate working at scale nor show how we could future proof long term healthcare provision to a growing population and thus did not gain support from the ERYPCT.
In early 2014 we lost our original development partner (GPI)
Contact has recently been made with the ERYCouncil’s Forward Planning and Housing Strategy Manager to seek views on potential alternative sites, either in the Council’s ownership or other allocated land which may be suitable for such development. One site in the Council’s ownership (the vacated Wolfreton School) was highlighted as being at least potentially suitable for such development – as part of a wider housing development. However, this land, is not yet offered to market and only benefits from outline approval– getting full approval and getting a start on site could take up to 2½ years. Assuming a development partner could be identified, construction would be a further 18 months to 2 years.
Although in a more central location to that proposed as the preferred site, it is not considered that access to the Wolfreton site is particularly good in terms of public transport – so whilst it may serve the immediate catchment area well this would not be the case for the majority travelling from across the wider practice catchment. There is no costed financial structure to match the current option - and our premises in Willerby do not have 5 years of sustainability that would protect us from having to seek list closure as the pressure of new and existing patient demand is already approaching maximum capacity. Other areas of land allocated in the Local Plan were discussed but these are generally the sites that were previously considered and rejected for a number of reasons (i.e. availability, cost etc…)
Relocate in Swanland: Conclusion. Swanland Surgery merged with Willerby Surgery in July 2014. At that time Willerby Surgery was in very early discussion with Lovel Development to identify a site for relocation. Throughout 2015/2016, as the business case for new premises was developed in conjunction with discussions with NHS England and East Riding of Yorkshire CCG, the financial case for a redevelopment was predicated on Willerby and Swanland Surgery being located in a single premises.
None of the comments and feedback have identified changes we can make to the current business case within a timescale we can achieve without losing this opportunity for relocation and working at scale to provide enhanced healthcare for patients over 20/25 years. There is no identified financial support for us to maintain premises in Swanland whilst relocating Willerby Surgery premises.
At the point of Willerby Surgery and Swanland Surgery merging into a single practice (July 2014) we were already in discussion with Lovel Development on an opportunity to locate Willerby Surgery into new premises at Anlaby.
At that time it was not expected that Swanland Surgery would be affected.
In 2015 we were in active discussions with another practice to co-locate into new premises. At the same time, other support for the opportunity was sought and conversations with the ERY CCG indicated that, whilst the strategic case was made, the financial situation showed no available funding and, whilst we were listed in the top 4 practices for premises development support all the then available capital was diverted towards other priority primary care developments within the ERY CCG area.
Ongoing discussions with NHSE during 2016/2017 eventually confirmed that success of any business plan for relocation would be predicated on working at scale, provision of a future proof building over a 20/25 year timescale and a cost neutral capital project.
Additionally it was clarified by ERYCCG that additional revenue support for the new premises would have to include combing the existing two premises revenue costs into a single cost rent for any new premises.
That precluded any option of operating from two premises - the practice cannot fund the costs of a branch surgery from its own resource, whether in Swanland or Willerby.
Our recent review with ERYCouncil Planning Authority did not identify any site within Swanland or on the periphery available for a new building. Further consideration of the likely impact on all our patients regarding a decision to relocate the whole of our patient services to Swanland would have a far greater negative impact on the majority (90+%) of our patients. Our conclusion was that redevelopment in Swanland is not an option.
Retain existing premises in Willerby: Conclusion Approximately one third of feedback from Willerby in relation to location commented on improving/retaining the existing premises.
The practice has three times previously looked into making possible improvements to Willerby Surgery and we have revisited the last business case, prepared in 2010.
Our conclusion is that the capital costs associated with developing and improving our current premises would not be borne by a developer and any gain in clinical space (essential to be able to increase the revenue payment from the ERY CCG) would not be sufficient to cover the capital outlay. With substantially less improvement in clinical capacity, the practice would not be able to demonstrate working at scale nor long term future viability to meet increasing patient demand from our existing base nor meet the needs of increasing numbers of new patients from the current and planned housing developments.
Making improvements to the existing Willerby premises could be done but would not demonstrate the required sustainability nor provide a cost effective, sustainable alternative, to relocation. Capital costs are not immediately available and upgrading will not provide sufficient extra clinical space. Without such an increase in clinical space there will be no extra revenue to fund the improvements and this option would be unlikely to happen.
The original 2006 survey showed the extent to which the premises would need to be improved to fully comply with the then Disability Discrimination Act. 12 years ago, these works were costed at £43K at that time.
During 2007/2008 the ERY PCT commissioned further work across East Riding practices and Willerby Surgery was identified as one of three priority premises to improve. However, no funding was available at that time
In 2008 we worked with an accredited developer (GPI) and costed the requirements to the existing premises and, with an estimate in excess of £500K we concluded this was not an effective solution and presented a business case for new premises to ERY PCT.
This business case was accepted and we proceeded to explore that option.
In 2012, having been unsuccessful in our relocation efforts, we revisited the option of developing the existing premises and entered into discussions with other occupiers on the present site in order to be able to extend the premises and re-provide better access/parking facilities.
The costs for this proposal (£1.3M) were submitted as a business case to ERY PCT but were not supported – mainly because we were unable to demonstrate working at scale or show future proof healthcare provision from the newly developed premises. Additionally we were unable to secure the necessary cooperation from the adjacent users to acquire the space needed for expansion.
As a result of the consultation exercise we have reviewed the 2010 proposals. Even with the cooperation of adjacent site users, the capital costs for redevelopment are unrealistic for the return on investment.
Retain existing premises in Swanland: Conclusion Just over half the feedback (23 comments) from Swanland patients suggested that the current surgery could be retained in Swanland.
The surgery building in Swanland is not owned by the practice and there is no capacity to expand clinical space and thus no capacity to meet any extra patient flow.
What we provide and maintain at the present time from these premises already falls short of the necessary standards expected of primary care and we are incurring higher premises costs than we are reimbursed for. Additionally, we are paying for duplication of staff, consumables, energy costs and support services which would be more effectively delivered from a single location.
It is unclear even if the new premises option does not go ahead, whether the Swanland premises can be financially sustained or whether any imperative to comply with regulatory standards would be achievable. If new premises are the eventual outcome, the financial reimbursement from NHS England/East Riding of Yorkshire CCG for Swanland would cease and the branch surgery could not then be maintained.
Swanland Surgery premises had been run by Dr R Clarke as a single-handed practice until 2013 when he entered into dialogue with Willerby Surgery to explore options to continue providing a service in Swanland. At that time the premises lease was due to expire and renewal by Dr Clarke was not a viable option.
The partners agreed to support Swanland through reduction in management and administration costs and at the same time maintain clinical cover by sharing resource from Willerby.
Maintaining the two surgeries as independent units became financially and logistically unsustainable and in July 2014, with agreement from NHSE/ERYCCG the clinical system was migrated and the patient lists were merged into a single practice list. That enabled better clinical management and support so Swanland could continue as a branch surgery.
The cost savings from the initial merger are no longer apparent as primary care has increasingly had to comply with changes in regulatory regimes and Willerby and Swanland Surgery is now operating with duplication of equipment, premises and utility costs, staffing support and clinical cover from a decreasing financial return.
5. Why the proposed site at Anlaby: Conclusion. As detailed in Section 1 and 2 above we have previously looked exhaustively at the possible sites in Willerby without success.
Lovell Development have been the only developer to offer to work with the practice to facilitate new premises.
Before committing to the offered location we undertook an initial appraisal of the suitability of the site. We considered the potential 1250 new homes for the local area plus the potential 150 planned in Swanland and the additional patients those homes would bring. We also considered the impact on our patient list from the impending decision by neighbouring Springhead Surgery to relocate their surgery out of Willerby further into Hull. We realised that if these houses were to be completed within a 2-3 year timeframe it would place an impossible demand on us to accept and provide primary care services to an additional 3000+ patients from our existing premises.
Lastly we looked at the geographical relationship of the proposed location to Willerby patients and Swanland patients.
The location would be closer to, and easier to reach from, Swanland than our existing Willerby premises (4.5km rather than 5km) has better road links and is approximately equidistant or closer to the majority (70+%) of our existing patient population.
Our recent contact with ERYCouncil Forward Planning and Housing Strategy Manager focused on potential sites in the Council’s ownership that may be available for a new surgery and other existing allocations which could be considered. It was confirmed that the only additional Council owned site within Willerby (the former Wolfreton School) has yet to be marketed by the Council. As explained earlier, this site is not considered to provide better transport access than our existing premises and the benefit to the majority of our patients from a move to Anlaby would not be achieved.
Having had no previous success in securing a development site, and with no other opportunities available within the necessary timeframe, we reached an agreement with Lovell Development to start the planning process and business case development process for possible relocation to Anlaby development.
The business case has been given initial support by NHS England and East Riding of Yorkshire CCG because it shows working at scale, demonstrates sustainability to provide a primary care hub to meet the future needs of up to 11,250 patients and it has the capacity to deliver a financially viable healthcare model.
With no other option showing the same level of benefit, deliverable within the next 18 months, relocation to Anlaby remains the preferred option.
The second most commented on issue (48 comments) concerned transport. The four principle elements of feedback were
Lack of public transport
Length of time when using public transport
Lack of personal transport
Negative environmental impact
Lack of Public Transport: The majority of feedback commented on the lack of bus services to the proposed location at Anlaby Low Road.
5.4% of our patients live in Swanland, the majority being within 1 kilometre of Swanland Surgery with very few on or near to a bus route; approx. 24% of our patients live within one kilometre of Willerby Surgery and approximately 2/3rds of those would be on or near to a bus route.
Most of our patients (70+%) already live more than a kilometre from the Willerby Surgery and are not on or close to a bus route, which means more patients would live equidistant to or nearer to the proposed location than current.
RESPONSE: We have always supported patients who are reliant on public transport, or transport by car from family or friends, by offering and arranging appointment times that mirror as closely as possible the bus times – or which fit in with the availability of car transport from family, friends and neighbours. And, whilst it is not our responsibility for patients’ transport arrangements, we will continue with this level of support regardless of location.
The official Hull bus network map (above) shows current routes serving Swanland and Willerby. The majority of these buses stop at the Red Lion, Anlaby which is approximately 400 metres from the proposed new premises location.
The bus timetable shows 14 buses between 9.00 and 6.00 each day from Swanland and 39 buses from Willerby – some of these buses stop at the bottom of Lowfield Road.
For Swanland the X80/180 has a two-hourly service from 09.35 from Swanland to the Red Lion, Anlaby
For Willerby the X80/180 runs 12 times a day from Willerby to the Red Lion
The EYMS Network Manager also confirmed to us that, whilst most of the current buses do not go down Lowfield Road, he would take account of the new development in any future service review. This is an extract of his email response :
“At present we have no plans to make any significant changes to services between Anlaby and Swanland but would be grateful if you could confirm any details on location, times etc that may be taken into consideration in any future service review.”
We will maintain contact with EYMS and ERY Council in the event relocation is the confirmed outcome so we can demonstrate to EYMS that, together with the substantial new housing in the same area, a case could be made to justify a minor route change to satisfy new, additional demand.
Length of Time when using Public Transport: There were a number of comments – mainly from Swanland patients - expressing concern about the length of time to make a journey to and from the proposed new location.
RESPONSE The 153 bus takes 14 minutes from Swanland to Red Lion, Anlaby – arriving at 5 minutes to each hour. The return bus leaves at 7 minutes past each hour – allowing a one hour turnaround for an appointment. An analysis of appointments over two weeks shows the average time in surgery from arrival to departure is 27 minutes.
We do not have any figures to indicate how long it currently takes patients to journey to the existing surgery premises, but the current bus timetable suggests most patients would have a turn-around time of 1 hour 35 minutes from leaving Swanland to return to Swanland.
We realise that, to achieve an average of 27 minutes, some appointments take longer and some are shorter. The longest time we measured was 1 hour 8 minutes (consisting of 48 minutes waiting and 20 minutes with a clinician). That longer time would add an extra hour on the total turn-around time. Although this is not desirable – and we would work hard to avoid this - we know it could occur for some patients reliant on bus transport. With the enhanced facilities from new premises there will be a better environment to wait in and we will review these facilities to include drinks, newspapers/magazines and free wi-fi for internet access.
2. Lack of Personal Transport: Some patient feedback indicated concerns from those who do not drive now and must rely on family or friends - and others were concerned that, whilst they are able to drive now there may come a time when they too must rely on others for transport. Some of that feedback suggested that that lack of transport to drive the greater distance to a new location would inevitably lead to an increase in demand for home visits.
RESPONSE As we have already noted, the majority (70+%) of our patients already live more than a kilometre from the Willerby Surgery and, excluding Care Homes residents, there are more registered patients aged 75yrs and older now within that group (990) than there are similar aged patients living in Swanland or Willerby (240). These patients are likely to be positively impacted by a premises relocation.
We do not know how many of those patients do not have personal transport. It is rare, however, that patients currently request home visits just because they cannot arrange transport to attend for appointments - not least because this would be an inappropriate use of our service.
3. It was commented by some that taxi fares from Swanland were indicated to be around £15 and this was going to be a cost burden. In the absence of using public transport, this may be a cost not currently faced by some.
RESPONSE We have met with, and are now working with, Humber and Wolds Rural Action Charity (HWRAC) who, amongst other activities, help organise volunteer schemes taking people who cannot use public transport and with no personal transport to attend doctor, hospital or dentist appointments as well as transport for shopping and social activities
Within the East Riding of Yorkshire there are several volunteer organisations operating Community transport services and two of these, Beverley Community Lift and Helping Hands, already work with HWRAC and operate services in this area.
We met with these organisers and all have indicated they would be happy to work with us and our patients to extend the schemes in the Swanland /Willerby area – not only to take patients to the proposed site - but also to expand to cover other personal and social needs for people.
This is a development in progress and, like everything, there will be costs for development of the scheme as well as ongoing running costs of such a scheme.
This would not be a free service to patients but costs are as low as possible and the more the service develops the more cost effective it would be.
At the beginning of June we hosted a Patient Group meeting and included this volunteer transport development in discussions about volunteering in general (something the surgery is very keen to encourage amongst our staff and patients).
This was very much welcomed and we will work to ensure we involve our patient group as much as possible. The practice is very keen to develop the concept of using any new premises opportunity to build up and host voluntary groups of patients as an integral part of managing their healthcare and improving social contact.
Should a voluntary transport scheme become a reality we will commit to working to facilitate appointment days and times as closely as possible with the availability of drivers.
4. Negative Environmental Impact: There was some feedback expressing concerns that moving to a new location will increase the amount of vehicle traffic and this would negatively impact on the environment.
RESPONSE This may be the case, depending on how patients choose to travel to a new location and whilst we do not have the ability to provide detailed numbers, we know that most patient addresses (70+%) are more densely located further away from the current premises and thus, conversely, they would be nearer to the proposed new location, thus minimising journey times.
We have confirmed with the consultant architects that the proposed new premises are built to achieve a minimum ‘Very Good’ BREEAM standard as required by NHS England.
BREEAM (Building Research Establishment Environmental Assessment Method) is the world's longest established method of assessing, rating, and certifying the sustainability of buildings. There are six recognised ratings: Outstanding, Excellent, Very Good, Good, Pass, Unclassified: and these are achieved by rating and scoring the environmental impact of different aspects of the building. For more detail about BREEAM please visit https://www.breeam.com/BREEAM2011SchemeDocument/Content/03_ScoringRating/scoring.htm
One of the key contributors to achieving high BREEAM rating is energy efficiency. The energy costs (average £1650pm) for a new building are forecast to be less than the current energy costs (average £1990) incurred from both existing buildings – this represents an ongoing 17% reduction on the environmental impact seen presently.
14 comments were made to raise concerns/questions about the adequacy of the number parking spaces to be provided at the proposed new site. Comments included that the staff parking would significantly reduce the numbers of spaces for patient use. There was also a comment that the surgery’s intention to provide additional services would further impact on parking provision.
RESPONSE Although the design/layout of new premises can be influenced by the intended occupier (us), the size and space allocations (including recommended parking spaces) are mandated by Department of Health specifications and referenced to BREEAM.
Other documents also govern new NHS provider buildings (eg: Department of Health : Health Technical Memorandum 07-03 and Primary and Community Care Health Building Note 11-01: Facilities for primary and community care services) include guidance on how spaces are calculated depending on, for example, number of patients, number and duration and times of appointments, other building uses, number of clinicians, number of staff, shift patterns, opening times etc.
The architect assures us that new premises are compliant with the relevant standards for a building designed for an eventual patient list size up to 11,250 within 10-15 years (our current list size is just over 8,700) and that the parking spaces provided are on target with the guidance.
Parking, then, will thus be more than adequate for our existing patients and our expected growth capacity over the next 15+years. Additionally there will need to be a travel plan agreed as part of the planning process which will oblige the practice to encourage car sharing for staff and to publish bus times etc for patients.
6 comments were received with questions/concerns during the meetings about potential issues obtaining repeat prescriptions, including that it would be more difficult to obtain prescriptions if patients had to travel greater distance to request them and/or collect them from the surgery.
RESPONSE: We already support a variety of ways for patients to manage their repeat prescription medication needs without them having to attend the surgery in person. We can receive requests by post, by fax, by online patient access and by request from pharmacy managed prescription services.
This will not change should we relocate, and we are always happy to give any patient online access to their medical record so they can manage prescriptions requests 24/7 from any computer or smart phone/tablet.
All the pharmacies we deal with offer to coordinate prescription requests from patients. This includes ordering prescriptions from us on behalf of patients as well as collecting the prescriptions when ready, and some pharmacies also offer a home delivery service.
We do not currently offer a telephone request service (except to the elderly/infirm or housebound) and we do not plan to extend telephone ordering from any new premises, however this would be reviewed in the light of technology changes and staff capacity, both of which should improve if we are able to increase our patient list. We understand many pharmacies do accept telephone requests at the moment but this is not within our control or influence.
13 comments were received with questions/concerns that making appointments would become (or remain) difficult and we have identified 2 main elements
Extra patients will place more demand on the appointment system
Appointments with choice of doctor
Extra Demand on Appointments Some comments referred to the extra patients we would take on in a new location and that these new patients would place greater demand on the appointment system making it harder to get an appointment.
RESPONSE: We are already at capacity for nurse space and doctor space in both premises - with approximately 2300 patients per doctor. The recommended ratio from the BMA is 1800 patients per doctor – with NHS England suggesting 2100 patients per doctor. The average list size across England is 1600 patients per GP. (2014 NHS/HSCIC figures)
The comments made are indicative of our increasing difficulty in meeting patient demand now and our patient list is increasing each week with no ability to increase our manpower
Our doctors have an average 32 patient appointments per day. Dr Mary McCarthy, vice-president of the European Union of General Practitioners (UEMO) and a member of the British Medical Association’s (BMA) general practitioners committee recently stated : “Around 25 contacts is safe.” (https://inews.co.uk/news/health/gps-doctors-patients-per-day-workload/)
Recruitment is exceptionally difficult where the working environment offers reduced/unsatisfactory facilities, space restrictions (resulting in a static skill mix) and a high number of patients per doctor. Without addressing these issues there is no way to improve appointment availability or avoid deterioration of current service levels.
We have 8 clinical rooms (none meeting current standards) and the options we have are limited and may result in us being obliged to restrict patient number growth. That is unlikely to have a positive effect on existing and new residents in Swanland, Willerby and, indeed, across our practice area.
Practices in modern, purpose-built buildings are more likely able to increase their healthcare team and improve the skill mix so that patients are seen more quickly by the relevant clinician. The proposed new premises would have an uplift to 14 clinical rooms plus multi-purpose healthcare rooms and more staff accommodation – all this will enable us to offer more appointments, better access and meet the needs of all our patients, existing and new.
2. Clinician of Choice Feedback also included comments over issues when trying to get an appointment with the doctor of choice.
Some of the comments appeared to relate to the current experience of some patients and one comment suggested that we were proposing to decrease the number of doctors and replace them with other clinical staff in the proposed plans for relocation.
RESPONSE: We have always aimed to support patients with an appointment with the clinician of their choice, but when demand for a named doctor exceeds the number of appointments with that doctor we simply cannot accommodate.
Most of our doctors have 16 appointments per clinical session so when 17 or more patients want to see that doctor we will not be able to comply with that request.
We do, and will continue to, offer an alternative doctor appointment where available but if a patient declines that the only remaining option we can offer is to call on a different a day/time.
That situation will not change irrespective of location and irrespective of the number of doctors available.
In the same way, regardless of which clinician is requested, when all the available routine appointments are fully booked then every appointment request after that will not be able to be fulfilled.
A mitigating action we would like to take – and one we will aim to take if we have larger premises – is to provide more non-doctor clinicians who can manage stable patients with a chronic condition without them needing to see a doctor. This would reduce the demand on the doctors, free up capacity and will mean that when a patients’ condition exacerbates, or they become acutely unwell, it will be quicker and easier for them to access a doctor and it will be more likely than now that their doctor of choice can be seen.
19 comments were made about the public meetings including that there was insufficient notice and that the meetings were not sufficiently well publicised and that relocation was sudden and unexpected.
RESPONSE: The planning process for the development of the new housing site in Anlaby included land provision for new surgery premises. That planning application was submitted to the East Riding of Yorkshire Council (ERYC) in March 2014.
We understand that the public planning process includes notification to town and parish councils and public consultations and the practice assumes ERYC followed appropriate process before granting relevant planning approval by the beginning of 2015.
When the developer advised that planning permission had been granted, the practice began the process of working with NHS England (NHSE) and East Riding of Yorkshire CCG (ERYCCG) to develop a business case that would be a strategic fit for the NHS and which was financially viable and sustainable over at least 20-25years.
By late 2017 we had developed a business case, including a Position Statement showing all the steps we had taken in the preceding years, and formally asked for support. In February 2018 we received outline approval from ERYCCG to progress our plans to the next stage and this was the trigger for us to engage with our patients.
We discussed and agreed our plans for patient engagement with the consultant working with us and the developer and with NHSE and ERYCCG and agreed the timescale at the Project Board Meeting on 27 February. These plans included the dates in April for the public events and we followed these plans and published the dates with the suggested 2 weeks notice.
This was by way of notices in both surgery waiting rooms, in Boots Pharmacy in Swanland and in the public library in Willerby. Additionally we published the meeting times and venues on our website alongside the options we were considering.
Following a meeting with ward and parish councillors ahead of the public meetings, two local councillors contacted local media and consequently the proposals and venues were also featured in the local press and on local radio.
There was very good turnout at both meetings and we believe we reached the patients we needed to. It may be that a meeting in Anlaby would also have been very well supported, however it is unlikely we would have received as much valuable insight.
Additionally, we are confident the number of comments and feedback we have received - at the meetings and subsequently - accurately reflect the concerns and issues, as well as support, from our patient population.
LACK OF DOCTORS
3 comments were made about doctor provision – one of which commented on current lack of doctors in Swanland, one commented that there being a shortage of doctors now would mean we would not have any success increasing the number of GPs in any new premises and one commenting that that the practice stated we did not need more doctors.
RESPONSE: Our current compliment of doctors do not have a sufficient clinical support team of nurses and other healthcare professionals to enable the practice to offer patients better access to monitoring clinics for chronic conditions. Such a team is better placed to work with these controlled patients to support them to remain as well as possible without needing to see a doctor. Achieving this will give the doctors more time to see the acutely unwell quicker and for longer. Without the benefit of extra space and facilities, we are not able to increase our team and are extremely concerned that this extra demand on the GPs will inevitably mean less access to a doctor than is the case now.
Many new doctors do not want to work within primary care in the same way as previously and the burden of premises is one key factor that dissuades many from working as GPs. Others cite out-to-date facilities and access to limited support from a wider team of healthcare professionals. As a training practice with Hull York Medical School we see that students who train in well-equipped surgeries are more likely to be retained or come back to primary care, thus helping with recruitment.
In the immediate future we are not looking to increase the number of doctors but rather seek to provide a multi-skilled clinical team with strategic partners, including Humber Health and CHCP Community Services, to work alongside our existing GPs to reduce the doctor input for stable chronic disease patient management and so enable better access for patients with urgent and acute problems to see a doctor sooner and for longer.
With improved facilities we will also be able to add greater value to our new doctor training programme and increase our role in the recruitment and retention of new doctors and nurses
12 comments were made in regard to pharmacy provision, including questions about an on-site pharmacy, concerns over the viability of local pharmacy in Swanland and access to repeat prescriptions (which has been dealt with above)
RESPONSE. The practice is prohibited from directing prescriptions and therefore the choice of which pharmacy to use belongs with the patient. If an onsite pharmacy is available it will not be under the direction or jurisdiction of the practice and the provision of this is a matter for the developer. The only interest the practice has is that, by making part of the proposed new building a commercial outlet, this improves the financial case for the proposed development.
DISPOSAL OPTIONS OF THE EXISTING WILLERBY SURGERY BUILDING
2 comments asked about the use/disposal of the existing surgery premises in Willerby.
RESPONSE. Continued use as a branch surgery is not being considered as there are no funds to support this (as explained previously). The building and land will be offered for sale and the actual use by any prospective owner, which will be different from the current use as a doctors surgery, will be subject to planning permission. This will be a public process and any interested person will be able to make relevant comments at that time to the East Riding of Yorkshire Council.
McCARTHY & STONE / PERSIMMON HOMES
The feedback summary provided to us by the local ward and parish councilors included a comment attributed to a representative from McCarthy & Stone who attended the Swanland meeting and was against the proposed relocation because the current GP surgery complimented the accommodation they were building for retirement living.
The letter from Willerby Parish Council suggested that we should contact Persimmon Homes who were holding an open meeting to launch their housing development plans on the land off Beverley Road, Willerby.
RESPONSE: We have no knowledge of the business plans of McCarthy & Stone nor Persimmon Homes so we are unable to comment on whether location of GP services is an integral part of their commercial process when deciding where to construct new developments.
However, we can state that we have not been approached by either McCarthy & Stone or Persimmon Homes – nor Beal Homes or any other housing developer currently building or intending to build within our practice boundary with the exception of Lovel Development – to ascertain what primary care provision we currently provide in Swanland or Willerby and whether such provision has the capacity to deliver a sustainable service to existing patients as well as the new residents of their housing developments.
We believe that, by recognising that the new housing developments already approved in the East Riding Local Plan will overwhelm us, we have been proactive in identifying the risk to primary care and seeking support from NHS England and East Riding of Yorkshire CCG to address our own concerns of inadequate premises and growth potential. The cooperation from the developer has enabled us to identify the land requirements, associated costs and opportunities for a sustainable, cost effective and strategic alternative to up-scale in a planned deliverable way to meet this rising demand and deliver high quality healthcare for many years to come.
We are grateful to everybody who has given feedback and acknowledge the support from those who have worked with us during our reviews to ensure we have responded fully.
We have not been able to identify any viable alternative proposals to put to our patients and, having considered the financial constraints, the lack of alternative viable options and the time imperative to deliver a sustainable outcome, we do not believe reopening the consultation process will serve to benefit ourselves nor our patients.
The practice remains committed to the preferred option to relocate and we will prepare a final business case to seek full support from NHS England and East Riding or Yorkshire CCG to go ahead with that option.
We remain committed to involving our patients in the logistics of any relocation. We will ask the Patient Group to work with us and HWRACC to develop the volunteer driver scheme and review our appointments system to make a relocation the most successful it can be for all our patients.
We may not be able to deliver the outcome every patient wants – but we will work hard to ensure that what we deliver meets our patients’ needs.
END OF FEEDBACK Willerby and Swanland Surgery 28 June 2018