Fname Lname Address 1 Address 2 Address 3 Town Postcode. Dear Fname Lname,

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1 Fname Lname Address 1 Address 2 Address 3 Town Postcode Dear Fname Lname, I m writing to you following our public meeting on Thursday 4th August 2016 regarding the future of GP services at Ashford Health Centre. Thank you very much for taking the time to attend and hear more about our consultation. The event provided an opportunity for a good discussion about the options available, and the future of healthcare in the Ashford area and helped the CCG to understand your views and concerns. We promised at the meeting to write to you addressing some of the questions that were raised on the night, to detail our vision for Ashford Health Centre and explain in detail why we currently believe that not renewing the current GP service is the right course of action. As explained at the start of our meeting, Ashford Health Centre s GP service is delivered under an Alternative Provider Medical Services (APMS) contract. These contracts allow healthcare commissioners, like ourselves, to award GP contracts to private companies on a more flexible basis and specify the delivery of additional services or opening hours, on a time limited basis. The current contract at Ashford Health Centre is delivered by Greenbrook Healthcare; who also run other healthcare services across Surrey, London and the South East. This consultation is not taking place due to any concerns about the quality or delivery of services by the current provider but because the contract is expiring. Greenbrook Healthcare s contract to run GP services at Ashford Health Centre began in July 2009 for five years. In 2014 the contract was extended by two years to 31st March 2017; for legal reasons we are unable to simply extend the contract further. This means we must now review and consider how we can best deliver healthcare to you and other residents of the Ashford area. The options available are: (1) Retender for another provider to supply NHS GP services at Ashford Health Centre. This contract may not offer the same services or hours of operation that your current GP service provides. Additionally, the contract would again be for a time limited period which would mean that you and other patients would be subject to further consultation and potential change nearing the new contract expiry date. (2) Allow the contract to expire, and support you to join an alternative practice providing long term service continuity. This would also enable us to further develop and deliver healthcare services for residents living in North West Surrey.

2 In either scenario a Nurse-led Walk-In centre will continue and from 1st April 2017 services will be provided by a new company, Surrey Central Health (subject to contract signature) following our recent procurement exercise to commission community health services for North West Surrey residents. We have summarised the key points raised at the meeting in the attached Appendix, and have included additional information to help address these. In the meantime, we will be continuing our consultation until the 11th September, with a further public meeting planned for Thursday 1 st September (also at Ashford Hospital, from pm). If you are yet to complete and return our consultation questionnaire you can complete an online version on our website at Following our consultation, we will summarise the responses we have received and incorporate them into a final document that will be submitted to our Primary Care Commissioning Committee for a final decision. We will of course let patients know of the outcome. If you have any further questions, please do get in touch by AshfordHC@nwsurreyccg.nhs.uk or call Yours sincerely, Julia Ross Chief Executive, North West Surrey Clinical Commissioning Group

3 Appendix: key points raised at the meeting on 4 th August Continuity of care During our consultation we have heard that patients want long term continuity of care which can only be provided by enabling patients to join an existing GP practice delivering services under a General Medical Service (GMS) contract. These contracts do not have expiry dates and therefore patients will not be subject to further consultation and potential change in the near future. There are nine practices in a two-mile radius of Ashford Health Centre who are delivering services under a GMS contract, and all have confirmed they are accepting new NHS patients; this is known as having an open list. Below is a table summarising the distance from Ashford Health Centre to each of these practices. Table 1: Nine practices within a two mile radius of Ashford Health Centre. Name of practice Distance from Ashford Health Centre in miles (closest to furthest) Stanwell Road 0.4 St David s Family Practice 0.6 Studholme Surgery 0.9 Fordbridge Medical Centre 1.0 The Orchard Surgery 1.3 Staines Health Group 1.6 Knowle Green Medical 1.6 Staines Thameside Medical Quality issues During the meeting some attendees expressed concern regarding the quality of healthcare offered at the alternative practices in the area. Using the latest published information from the Quality and Outcomes Framework (QOF) which we use to assess practices we have compiled the table below which compares local practices across three key health areas: asthma, diabetes and smoking cessation (higher scores represent higher quality assessments).

4 Asthma Diabetes Smoking We have also looked at patient experience, taken from the latest patient survey of GP services. The following table shows how all nine local practices, including Ashford Health Centre, score across a number of key questions (again higher scores are better) who find it easy to get through to this surgery by phone who usually get to see or speak to their preferred GP who were able to get an appointment to see or speak to someone the last time they tried who usually wait 15 minutes or less after their appointment time to be seen 3. Availability of GP appointments Some attendees expressed concern about the availability of GP appointments. Whilst we recognise that the hours of delivery at Ashford Health Centre are unique extended opening hours are available at some of the other local practices. I want to reassure you that some

5 services will continue to be delivered on a walk in basis at the existing Walk-In centre, which will remain and continue to run. 4. Financial issues We also took questions on the financial implications of either option and had a request for further information. North West Surrey CCG has a defined budget for Primary Care and must ensure that commissioned services best meet the needs of its entire population and deliver best value for money. NHS resources are finite, unfortunately we don t have the financial resources available to do everything that we or our population want therefore we have to make difficult decisions. When reviewing our options for the future of this contract we have had to acknowledge that the Ashford area is well served by GP practices, who are all accepting new NHS patients. This proves that there is sufficient capacity to deliver services to patients who would be displaced if we made the decision not to reprocure the existing services. In addition, we are aware that it is likely we would need to significantly increase the budget to secure new GP services to make the contract financially attractive to potential providers. This is a financial risk for the NHS in times of reduced finances, and would reduce our ability to develop new services for the benefit of all patients in our CCG area. 5. Other issues Several patients wanted to know why, when they had only recently registered at Ashford Health Centre they were not informed that the GP practice may be closing. Whilst we recognise the disappointment and inconvenience that this may cause patients cannot be refused registration until a decision has been made about the future of the contract, this would be a breach of regulations. However, we have agreed with the practice that any new requests for patient registration can be informed about the consultation and the potential for change. 6. Our wider vision for local health services Our wider vision for Ashford Health Centre and GP services across North West Surrey aims to deliver improved access and enhanced services for all patients. We have developed a model of care in Woking to support vulnerable patients; known as the Bedser Hub. The new model of care provides a one-stop multi-specialty service delivering pro-active care to vulnerable patients. We want to roll out this model across the North West Surrey area. Much work is being done with our partners and patients groups to define what this might look like and how we can accelerate this in the Ashford area. This approach ties in with our wider Primary Care Strategy, which is to increase GP lists enabling practices to provide services at scale and support additional GPs and primary care staff to deliver services to patients in more effective ways. We also want to support patient groups having a strong voice in local practices.