Strathmore Surgery Issue Q&A On Proposed Boundary Changes

Strathmore Medical Practice has issued their response to issues raised regarding proposed changes to surgery’s patient / location boundaries. 

Last month it was reported that Strathmore Medical Practice on Chester Road was considering reducing their patient location boundaries. This would mean patients who fell outside of the proposed new boundaries would have to seek an alternative GP and surgery.

A letter was sent out to those who fall outside the proposed boundaries, stating that due to an increase in patient demand, the size of the surgery and not wanting to compromise on the level of service, the surgery was considering introducing new boundaries.

The letter also stated that: “Our proposal is for a reduction of patient numbers so as to match the available resources at Strathmore.”

The proposed new boundaries will cover areas such as Rhostyllen, Hightown, the Industrial Estate and Borras. This is despite locations such as Borras and Gresford already having a GP in their local area.

Following a request by the CHC (Community Health Council),  Strathmore Medical Practice has prepared it’s response to a number of Frequently Asked Questions.

Concerns were raised by current patients who have used the surgery for a number years, who wanted to know why the surgery didn’t adopt a ‘Last in, first out approach’. However Strathmore have replied saying: “We understand that many of our long-standing patients may feel our proposal is unfair. However, our recommendations are not simply about patient numbers. We are also trying to make the area we cover more manageable from a clinical perspective.” 

Some of the patients at the surgery have already found an alternative GP to see, however there are incidents were people have been turned down due to falling outside the boundaries of more than one surgery.

They have also reassured current patients that no one has been deregistered from the surgery lists, and that ‘closing surgery lists is not normal practice’.

Another issue that was raised was by patients who live relatively close to the surgery, who had found they fell outside the proposed boundaries. Whereas those who lived slightly further away, would still be able to use Strathmore. The surgery has said: “Many things were taken into account when drawing up the proposals. Along with travelling distances we also considered population density, and ease of access (i.e. roads, travelling time) for patients and GP’s. Our GP’s have plenty of experience of visiting patients throughout the area and the proposed boundary is our best attempt at taking all relevant factors into account.”

It is also stated further into the Q&A that the current proposals to boundary changes, are the ones that are most favored / preferred.

The full Q&A are listed below, covering a range of issues, including how the whole process has been arranged / discussed, a deadline for patient responses and which local representatives have been informed.

How has the Exercise been arranged?

The Surgery took its proposals to Betsi Cadwaladr University Health Board earlier in the year. It was agreed that a patient engagement exercise should take place in order to identify potential concerns as well as positive feedback that could help the Local Health Board consider the request.

The Surgery then approached the Community Health Council (CHC) for their assistance. It was agreed that the surgery would write to the patients who might be potentially affected. To make patients aware of the proposals we also advertised the exercise within the surgery through notices and leaflets as well as updating our website. We have also contacted local Councillors, Ian Lucas MP and Lesley Griffiths AM.

The CHC will consider both the responses received by the surgery and the responses it received directly from patients and then provide the Local Health Board with a report outlining the CHC’s views on the engagement exercise and the proposals. The Health Board will then take account of the CHC report in reaching a decision.

What local representatives have been informed?

The surgery has provided all local councillors with information about the proposals. We have also contacted local representatives Ian Lucas MP and Lesley Griffiths AM.

The initial letter to patients was unsigned and addressed to “the Occupier”. This comes across as impersonal. Why did you not write to individuals?

We are eager to keep costs to a minimum so as to ensure that as much of our available resource as possible is used to provide health services. We therefore used an automated mailing service. We chose to write to occupiers rather than individuals to avoid sending more than one letter to each affected home, which is an approach that has also been used by other surgeries contacting their patients to gather views on proposed service changes.

Why are there some areas of the proposed boundary further away from the surgery than some parts that might be removed?

It would be impractical to apply a straightforward circular boundary.

After much thought we have proposed using boundaries which are easily identified on a map, such as the A483, to make clear the area we would cover.

Many things were taken into account when drawing up the proposals. Along with travelling distances we also considered population density, and ease of access (i.e. roads, travelling time) for patients and GP’s. Our GP’s have plenty of experience of visiting patients throughout the area and the proposed boundary is our best attempt at taking all relevant factors into account.

Is there a deadline for responses – i.e. closing date for the engagement exercise?

This was open-ended. However, following discussion with the LHB, responses received by the end of the first week in September will form the bulk of the engagement exercise to be considered as part of the Practice’s application to reduce its boundary
Once a final decision is made on the proposals – when do you anticipate implementing  them should they be agreed?

This is something that the Local Health Board will have to consider. Timescales and procedures for these situations will fall within their remit.

Can patients be forced to leave? Be deregistered?

This will be for the Local Health Board to decide. At this stage we are simply making proposals.

What consideration is being given to patients who are facing exceptional circumstances? E.g. difficult pregnancies/ elderly and infirm?

Patients who are terminally ill and on the End of Life Pathway will not be asked to register elsewhere.

There is a perception that patients are being deregistered already and that this is a done deal. What are you doing to allay these concerns?

Our patient letters and leaflets clearly state that no decision has been made.

It might be that some patients are anticipating an outcome that has yet to arise and are wishing to make a move now rather than later.

Our staff are giving accurate advice to patients.

Could the proposed boundaries be revisited?

We have given a lot of thought to this and the current proposal is our preference. However, the purpose of the engagement exercise is to allow all views to be considered.

Are patients being offered a list of alternative practices?

The Local Health Board have said that they would be dealing with this as part of the roll out process.

If a decision is made to go ahead with the proposal, how will this be rolled out?

We would expect the Local Health Board to provide help and guidance in making the transition a smooth one for both the surgery and those patients affected.

If the surgery wishes to reduce patient numbers, why not use a “last in first out” approach.

We understand that many of our long-standing patients may feel our proposal is unfair. However, our recommendations are not simply about patient numbers. We are also trying to make the area we cover more manageable from a clinical perspective.

Why doesn’t the Surgery close its list?

It is not normal practice for surgeries to close their list.