Shrewsbury Health and Wellbeing Hub: Open letter

In response to an open letter received from five local retired GPs, Dr Charlotte Hart – Clinical Lead for the Shrewsbury Health and Wellbeing Hub – has addressed the concerns raised.

Thank you for your letter regarding the proposed Shrewsbury Health and Wellbeing Hub and for sharing your concerns.

The project team (of whom I am simply one part) are collating all of the queries that we receive about the hub and are updating a set of frequently asked questions on a regular basis so that all of these concerns are captured, and answers given.

I would also direct you to the Case for Change that is on the website as it provides a lot of the information that you seek. This information has been freely available to the public for a few months now, I can assure you there is no intention to cloak this project in secrecy. The link to this page is here. I would also like to address some of your concerns explicitly.

Regarding “polyclinics” - the team would argue that this is not a polyclinic of the type that you describe. The six practices will retain their identity, will have separate reception space for the patient check in and waiting rooms and will have clearly defined areas that their practice works from. Some of the back-office functions may be shared (document management etc) but this work has been going on for some time and was being planned prior to the proposal of the hub.

Alongside the practices, some other services will be co-located. You will all remember the wonderful days when we had District Nursing teams working from our practices. The aim is to have services like this within the building, these discussions and considerations will continue to form part of the ongoing engagement and involvement activity planned with the population. The formal, public consultation is planned to find out what would be helpful to have in the building alongside the usual services that people expect from their GP.

You mention how general practice was some years ago, yet general practice has not stayed the same. It has had to adapt and change owing to a variety of factors. The days where GPs would send patients to the hospital to have their diabetes and hypertension managed by specialists are long gone. GPs are conducting more appointments now than ever before and are truly the general specialists of medicine. Yet they continue to engage with their population over a wide range of diseases.

People will be able to continue to see clinicians from their practice even if it is in the proposed hub. The proposal does not mean that healthcare staff will be lost, in fact it will enable practices to recruit more staff members because there will be more space. We will also be able to work collaboratively with other partners (e.g., the community trust and the mental health trust) to provide more timely care and support for our population.

You mention recruitment and retention. All of you left clinical practice some time ago and all of you found it challenging to find partners to replace you who were happy to take on the burden of property ownership. As you will be aware, two of you have been and still are the landlords for the practice that you retired from, and you continue to receive annual rent from this building accordingly.

In the spirit of openness and transparency, have you shared this conflict of interest when protesting against the hub? Young GPs do not want to take on a mortgage that is larger than the one they have on their own home. The financial burden is significant and is affecting the partnership model in a far more negative way than the proposed hub.

You mention the size of the building and that it will need a large car park. This is part of the plans being proposed. You seem to imply that a large building is a bad thing but I’m not sure why – the architects are proposing a building that is light and spacious and easy to navigate.

Darwin Health Ltd is a small company that is independent of any of the plans for the hub and has no role in its development. There is no conflict of interest or financial gain for the directors.

The project team welcome ongoing dialogue and comments about the proposed hub. We would like to highlight again that the hub is a proposal. It is not a done deal. The outline business case hasn’t been submitted.

NHS Shropshire, Telford and Wrekin is following all the procedures laid down by NHS England around engagement and consultation. There is no secret committee that is plotting and planning to do things in secret. The public consultation will be starting later in the year and will be asking people who are registered with the relevant practices and the wider community for their opinions.

I would respectfully request that these opinions are constructive and wish to enable all voices to be heard. Practices are working with their patient participation groups to ensure that those who are in favour of the proposal are also able to express their views as well as those who are not.

Your sincerely,

Dr Charlotte Hart

Clinical Director Shrewsbury Primary Care Network

Clinical Lead for Shrewsbury Health and Wellbeing Hub