A ROSE is a ROSE is a ROSE (Gertrude Stein, 1935) Part III
In part one I gave a short account of why ROSE was conceived and its purpose and aims. In part II I gave a ‘potted history’ of some of the events and behind the scenes machinations that dogged the closure of the post office. In part III I will cover the pharmacy and the GP branch surgery.
The Pharmacy
The story of the demise of J&A Pharmacy is the simplest of the three tales to tell. As mentioned in part II this was a commercial decision taken by the owners to consolidate their services at their Welland Vale Road shop, the closure of the post office being a by-product of this decision.
Following a Freedom of Information request the ICB[1] sent me the following statement:
“The ICB were notified of the consolidation application under regulation 26A of the National Health Service (Pharmaceutical and Local Pharmaceutical Services) regulations 2013 as amended on 01 December 2023 of the closure of the pharmacy located at 19-21 Main Street, Evington and the services being consolidated at 49 Welland Vale Road, Evington. The timeline for this type of application is 4 months. This was approved at the Pharmaceutical Services Regulation Committee on 04 March 2024, and a notice of consolidation was received with an effective date on 05 December 2024. The Pharmacy is an independent service provider and conducted a consultation process prior to submitting an application to the Pharmaceutical Services Regulation Committee where the decision was taken to approve the consolidation of the pharmacies in Evington. During the application process interested parties were also contacted. This includes other community pharmacies plus the Local Pharmaceutical Committee, Local Medical Committee, Healthwatch and the Health and Wellbeing Board in order for them to make comments. No representations were received at the time of this decision.”
From this it can be seen that no consultation with the wider public took place at all and it seems the Practice and the ICB are not compelled to do so. As with the GP branch surgery (See below) there seems little sympathy with the local population’s needs or wishes. The ICB has a responsibility to ensure that pharmacy provision is made for the population it covers.
GP Branch Surgery
The Integrated Care Board (ICB) decided, after a very poor consultation exercise conducted by the GP Partnership, to close the Evington Common branch surgery on 13th December 2024. This was on top of Evington Village post office and pharmacy closing.
Evington Surgery has provided an excellent GP and nursing service for decades. It was never designed as an all singing all dancing service, simply as a local branch surgery. The two main reasons for closure put forward by the GP Partnership and the ICB were that the practice had been given notice by Dr Wood, who retired in 2023 and is the landlord, that he is selling the building.
The second reason, articulated well in wordy documents produced by the ICB, is that the building is not suitable as a modern-day GP practice and the GP Partnership could not afford to buy it and pick up the cost of upgrading it. The truth of the matter is the building was never intended to be a modern-day GP practice offering multiple specialty services and that is serves its population well as a branch surgery in a building that may well need some small remedial works.
The bullying tactics used by the ICB of allowing consultation which appears to breach fair consultation principles, ‘Gunning Principles’ to sway a flawed decision, is reprehensible, specifically:
- consultation must take place when the proposal is still at a formative stage.
From the start it has been clear from the consultation that closure was the only option being considered.
- sufficient reasons must be put forward for the proposal to allow for intelligent consideration and response.
The reasons for the closure appear to hold little truth as outlined above.
- adequate time must be given for consideration and response.
The ICB has refused to listen to reasonable argument and after calling a public meeting with three days’ notice and ignoring reasoned argument against closure, wrote to participants to announce the closure date.
- the results of consultation must be conscientiously taken into account.
The paucity of responses to the consultation, 84 in total, is testament to the failure of the consultation process itself. In addition, from those 84 responses 51respondents (61%) opposed the closure and only 25% agreed with it.
It seems the ICB which serves all of Leicestershire and Rutland are a law unto themselves with little regard for the public they are paid to serve.
The ICB stoically ignored suggestions from Councillor Haq to give the surgery a stay of execution over the winter and allow it to remain at least until spring 2025. Also giving us time to make the case for its retention.
We were told the branch surgery had to close because Dr Wood had given notice to St Elizabeth’s Medical Practice that he intended to sell. This was presented as formal notice with a time scale attached by Sarah Russell Deputy Mayor and at no time did the practice or anyone at the ICB or City Council disabuse us of this fiction. The fact uncovered by Zuffar Haq in conversation with Dr Wood was that indeed, in his eighties, he wished to relinquish responsibilities for the building and landlord nighttime callouts for alarms and other issues, but he sorely wished to sell to another GP and maintain the service for his patients. Dr Wood lives close to the practice and felt strongly for his patient’s welfare. Three separate GP practices approached Councillor Haq expressing an interest in running the surgery, but the ICB refused on the grounds it was not fit for purpose. This again was a fiction. They were comparing it to a modern-day practice with multiple services on one site such as physiotherapy, pharmacy, nursing services etc. As a branch surgery, highly regarded by patients, offering solely GP and nursing services, it was never intended to provide anything other than that. Sure, the building had a few issues, but these had remained for decades and could have been resolved over time with some investment, curiously now available from central government. The remedial issues put forward included:
“fire safety and access; namely that there was no dedicated fire exit, no fire safety lighting, only one smoke alarm throughout the premises and wheelchair access was limited. The windows did not fully open as there were metal bars at the window for security purposes and ventilation in the consulting room was only possible by climbing on to the consultation couch.”
Given the size of the building and it being on the ground floor, there is no need for an alternative fire exit. Fire safety lighting and additional smoke alarms are cheap and easy to remedy. The wheelchair access is easily resolved as are the windows, simply by removing the bars and fitting more robust windows or fitting bars that allow window opening. As to ventilation in the consulting room, a window pole with a Velux window would seem the easy option. The sum of these problems is relatively cheap to resolve and does not make them a barrier to occupation.
Curious also that three other practices felt they could provide services from the 10 The Common and made enquiries about doing so.
When I wrote to the City Mayor to garner his support about the pharmacy and the GP branch surgery closures, given the City Council boasts of its support to the people, communities and businesses of the city and their support for maintaining vibrant High Streets, his response was to wash his hands of matters. He simply referred to these being commercial decisions as though the City Council had no interest and no responsibility in the matter.
This is again another fiction as local councils must work closely with their NHS commissioning colleagues as part of the ICB and even have the power to seek the intervention of the Minister in cases of reorganisation such as this.
Having exhausted all local appeals, the matter was referred to the Parliamentary and Health Care Ombudsman. The ICB then decided to carry out a review of their processes and as such the matter is now suspended awaiting the outcome of the review.
[1] The ICB operates as a unitary board, with membership including (at a minimum); a chair, chief executive officer, and at least three other members drawn from NHS trusts and foundation trusts, general practice and local authorities in the area. In addition, at least one member must have knowledge and expertise in mental health services. ICBs have discretion to decide on additional members locally. Each ICB must also ensure that patients and communities are involved in the planning and commissioning of services.
