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interestrateripoff

Hundreds of GP surgeries could close as NHS hikes rent charges by as much as 1,000 per cent

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Hundreds of GP surgeries could close as NHS hikes rent charges by as much as 1,000 per cent 

  • NHS Property Services (NHSPS), which manages buildings, increased charges
  • Charges backdated to April 2016 so some face bills costing tens of thousands
  • Some will close and others say they may have to cut nurses and support staff 
  • One health care centre in Surrey  a rise from £755.46 to £8,800 per month 

Anyone know what's behind the headline?  Is this PFI coming back to haunt the NHS?

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39 minutes ago, interestrateripoff said:

Anyone know what's behind the headline?  Is this PFI coming back to haunt the NHS?

NHS property services is a government owned Ltd company which was created during the latest reorganisation of the NHS.

When strategic health authorities were abolished and replaced with CCGs (which had a more administrative, rather than overarching role), the properties owned by the SHAs were transferred to NHSPS. These properties were typically things like clinics, GP surgeries, etc.

GPs have always been private firms contracting services to the NHS, but in many cases, they frequently they would rent the surgery building from the SHA. These rents have historically been massively subsidised.

As part of the reorg, NHSPS has been required to bring rents into line with local market rents for similar style commercial premises. This has led to rent rises of 10x or more.

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For what GPS get paid and what they charge the average Joe, I am sure they can afford it, looks like it's only 2 bottles of gin this week darling and not 4.

£30 for a Doctors signature.......hell I wouldn't pay that for Man Utd's signature (yes the whole team)

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1 minute ago, HaveAniceDay said:

For what GPS get paid and what they charge the average Joe, I am sure they can afford it, looks like it's only 2 bottles of gin this week darling and not 4.

£30 for a Doctors signature.......hell I wouldn't pay that for Man Utd's signature (yes the whole team)

The definition of drinking too much: drinking more than your gp. :)

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I can't think many Doctors would vote Tory in the next election?

*7 day surgery opening (striked over?)

*Junior Dr working conditions (striked over)

*Time to Raise The Rents

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10 hours ago, ChumpusRex said:

NHS property services is a government owned Ltd company which was created during the latest reorganisation of the NHS.

When strategic health authorities were abolished and replaced with CCGs (which had a more administrative, rather than overarching role), the properties owned by the SHAs were transferred to NHSPS. These properties were typically things like clinics, GP surgeries, etc.

GPs have always been private firms contracting services to the NHS, but in many cases, they frequently they would rent the surgery building from the SHA. These rents have historically been massively subsidised.

As part of the reorg, NHSPS has been required to bring rents into line with local market rents for similar style commercial premises. This has led to rent rises of 10x or more.

How many GPs are in SHA property?

I know mine is in a privately onwed building. Ditto my kids. Ditto my parents.

I get tired of the whole 'my GP is wonderful, dont try and privatise the NHS'

The comedy thing is a semi famousen nieghbour going into OTT praise for the 'NHS', then prasiing the local GP (private contractor) and slagging of the hospital (public) as it keeps cancelling operation - mainly due to to staff not turning  up to work (confirmed by a Nurse friend who works at the hospital).

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I started my working life a long time ago as an accountant specialising in GP partnerships. (so info may be a little out of date!)

However, two things were known.

1. Don't go to lunch with the partners if you needed to do any kind of accurate work in the afternoon. 5 large G&T's doesn't go well with bank reconciliations.

2. The practice building was a great way to make additional money. The partners would borrow the money to buy / build the surgery, and would rent it back to the Health Service at a very healthy markup. It was very early buy to let but the taxpayer was the mark.

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15 hours ago, interestrateripoff said:

Anyone know what's behind the headline?  Is this PFI coming back to haunt the NHS?

Nothing to do with PFI.

Essentially, many gp surgeries (particularly the one man bands) are unsustainable. There is now too much bureaucracy (managing the business, cqc inspections, etc), they don't make any money. Young doctors won't come in to replace them, locum costs are too high, basically there's no resilience there. There is also a lack of competent practise managers.

This is the nhs gently nudging practises towards combining in larger groups with more cover and more money who can hire better practice management and invest in technology which means the hypochondriac can be told to stay at home and drink some water for their headache via their tablet instead of clogging up the appointment schedule. 

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1 hour ago, Hullabaloo82 said:

Nothing to do with PFI.

Essentially, many gp surgeries (particularly the one man bands) are unsustainable. There is now too much bureaucracy (managing the business, cqc inspections, etc), they don't make any money. Young doctors won't come in to replace them, locum costs are too high, basically there's no resilience there. There is also a lack of competent practise managers.

This is the nhs gently nudging practises towards combining in larger groups with more cover and more money who can hire better practice management and invest in technology which means the hypochondriac can be told to stay at home and drink some water for their headache via their tablet instead of clogging up the appointment schedule. 

My large surgery merged with another large surgery a couple of years back - they've got dozens of doctors and nurses and are part of a larger medical centre with all sorts of outpatient clinics and diagnostics (blood tests, x-rays etc). It's really good.

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2 hours ago, Hullabaloo82 said:

There is now too much bureaucracy (managing the business, cqc inspections, etc), they don't make any money. 

There's certainly plenty of money to be made in healthcare; it's just a question of extracting it from those with the ability to pay. But the bureaucracy which is intended to ensure high quality care for everyone is going to make high quality care unaffordable for those without the ability to pay.  I guess I can take out a loan?

2 hours ago, Hullabaloo82 said:

... which means the hypochondriac can be told to stay at home and drink some water for their headache via their tablet instead of clogging up the appointment schedule. 

The hypochondriac, the obese, the smoker, the person who doesn't exercise, the old, the mentally ill and the incurable ....all clogging up the appointment schedule. 

Those who want cheap interventions with high insurance profit margins are going to be welcome.  There's plenty of scope for the marketing of scans and preventive check ups, until a serious illness develops. 

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1 hour ago, This time said:

My large surgery merged with another large surgery a couple of years back - they've got dozens of doctors and nurses and are part of a larger medical centre with all sorts of outpatient clinics and diagnostics (blood tests, x-rays etc). It's really good.

Sounds fine and dandy. But usually in the supermarket surgeries you're lucky to get to see the same GP on a regular basis. It may be your experience is different. A GP who sees the same patients is more likely to remember and understand their problems than one who has 10 minutes and may never see you again.

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5 minutes ago, Sterling Loss said:

There's certainly plenty of money to be made in healthcare; it's just a question of extracting it from those with the ability to pay. But the bureaucracy which is intended to ensure high quality care for everyone is going to make high quality care unaffordable for those without the ability to pay.  I guess I can take out a loan?

The hypochondriac, the obese, the smoker, the person who doesn't exercise, the old, the mentally ill and the incurable ....all clogging up the appointment schedule. 

Those who want cheap interventions with high insurance profit margins are going to be welcome.  There's plenty of scope for the marketing of scans and preventive check ups, until a serious illness develops. 

To be fair, my GP mate's surgery *is* filled up hypochondriacs, the old and obese smokers.

The only people who struggle to get an appointment are the people paying for the service who have to work rather than sit around blockign up the surgery.

A £20 appointment charge, no exceptions, would clear out the GP system.

 

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1 hour ago, spyguy said:

To be fair, my GP mate's surgery *is* filled up hypochondriacs, the old and obese smokers.

The only people who struggle to get an appointment are the people paying for the service who have to work rather than sit around blockign up the surgery.

A £20 appointment charge, no exceptions, would clear out the GP system.

 

Yes, it's true in my experience too, and charging £20 would remove many consultations which are as much for social contact as anything.  But then we're moving away from a universal healthcare service and easily treatable problems will be missed, for those who can't afford it.

Obviously change is needed, but letting in people who want to take as large a cut of resources available as they can and who aren't actually providing healthcare doesn't seem like the way forward.

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32 minutes ago, spyguy said:

To be fair, my GP mate's surgery *is* filled up hypochondriacs, the old and obese smokers.

The only people who struggle to get an appointment are the people paying for the service who have to work rather than sit around blockign up the surgery.

A £20 appointment charge, no exceptions, would clear out the GP system.

 

Problem with that is that the hard of working will get the bennie ticket exemption and those actually working and paying for it will yet again be charged. 

A 10 pound charge that ALL pay plus a five pound charge for perscriptions that again ALL pay regardless. 

Will have the sjws up in arms mind  

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38 minutes ago, One-percent said:

Problem with that is that the hard of working will get the bennie ticket exemption and those actually working and paying for it will yet again be charged. 

A 10 pound charge that ALL pay plus a five pound charge for perscriptions that again ALL pay regardless. 

Will have the sjws up in arms mind  

A £20 appointment charge, no exceptions, would clear out the GP system.

Another friend is a specialist Nurse in the hospital hearing clinic.

To keep the clinic open they need to treat X number of patients.

Not a problem - lot of tests need to be done - kids, OAPs, etc.

However - they currently average ~30% no show, which pushed them below the number they need to stay open.

If there was a charge assocuated with the clinic then a) people would not be blase about booking it b )  theyd probably turn up.

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1 hour ago, Sterling Loss said:

Sounds fine and dandy. But usually in the supermarket surgeries you're lucky to get to see the same GP on a regular basis. It may be your experience is different. A GP who sees the same patients is more likely to remember and understand their problems than one who has 10 minutes and may never see you again.

This is an interesting issue. We all have this romanticized notion of the local gp as all round problem solver and confidante. 

Maybe this was possible 30 years ago. Nowadays, in the cold light of day your gps ability to remember where you went on holiday last year has no bearing on health outcomes. What will have an impact is seeing staff who are able to take time off and aren't rushed off their feet trying to combine being a doctor with running a small business. 

The issue with GPS only having 'ten minutes to see you is precisely why they're pushing towards larger practices with more staff.

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11 minutes ago, spyguy said:

A £20 appointment charge, no exceptions, would clear out the GP system.

Another friend is a specialist Nurse in the hospital hearing clinic.

To keep the clinic open they need to treat X number of patients.

Not a problem - lot of tests need to be done - kids, OAPs, etc.

However - they currently average ~30% no show, which pushed them below the number they need to stay open.

If there was a charge assocuated with the clinic then a) people would not be blase about booking it b )  theyd probably turn up.

Agree.  It is the principle that some pay (again) whilst others don't. There should be no exemptions for prescription unless a serious condition and then only the medicine associated with that condition should be free 

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1 hour ago, Hullabaloo82 said:

This is an interesting issue. We all have this romanticized notion of the local gp as all round problem solver and confidante. 

Maybe this was possible 30 years ago. Nowadays, in the cold light of day your gps ability to remember where you went on holiday last year has no bearing on health outcomes. What will have an impact is seeing staff who are able to take time off and aren't rushed off their feet trying to combine being a doctor with running a small business. 

The issue with GPS only having 'ten minutes to see you is precisely why they're pushing towards larger practices with more staff.

I don't think it's so much about having a confidante as seeing a GP who has more back up than scanning patient notes for 30 seconds before seeing the patient.  A GP who has a treatment rationale and understands my history is more likely to help and less likely to inadvertently kill me than one who I've never met.

Not knowing patients and having to record and document every decision in great detail is immensely stressful.   Reducing the bureaucracy would help.

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22 minutes ago, spyguy said:

A £20 appointment charge, no exceptions, would clear out the GP system.

Another friend is a specialist Nurse in the hospital hearing clinic.

To keep the clinic open they need to treat X number of patients.

Not a problem - lot of tests need to be done - kids, OAPs, etc.

However - they currently average ~30% no show, which pushed them below the number they need to stay open.

If there was a charge assocuated with the clinic then a) people would not be blase about booking it b )  theyd probably turn up.

It would also mean the poorest in society do not have access to a GP

£20, hell even £10 is a major amount of money for some

To solve your no-show problem, rather than charge up front, issue a fine if missed appointment - including dipping into people's benefits money before they get it. 

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1 hour ago, spyguy said:

A £20 appointment charge, no exceptions, would clear out the GP system.

Another friend is a specialist Nurse in the hospital hearing clinic.

To keep the clinic open they need to treat X number of patients.

Not a problem - lot of tests need to be done - kids, OAPs, etc.

However - they currently average ~30% no show, which pushed them below the number they need to stay open.

If there was a charge assocuated with the clinic then a) people would not be blase about booking it b )  theyd probably turn up.

Would you charge £20 at A&E too? If not they could be overwhelmed by people wanting to avoid fees.

Sometimes hypochondriacs do get seriously ill, and people with personality disorders who want to be looked after (with absolutely no benefit to them) will kill themselves.

When it does happen, the documentation shows someone is at fault for ignoring a person in distress, and GPs/nurses jobs are at risk, as well as often being pilloried in the press.

If resources are being reduced, or targeted more effectively, we have to accept these negative outcomes as part of the solution.  It's a lot harder to do this if you think of it as happening to someone you care about rather than a statistic.

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