Carlisle GP practice came close to folding, doctors reveal

The revelation comes amid the closure of a Whitehaven surgery, blaming the growing pressures on general practice across Cumbria, and prompting fears others may also be at risk.

Doctors behind Carlisle's super surgery say it was a near crisis that prompted the controversial merger of three city practices - St Paul's, Brunswick House and North Carlisle.

Had that not happened, they say it is likely the North Carlisle practice would have suffered a similar fate to Whitehaven Medical Centre, which is closing next week affecting over 4,000 patients.

Carlisle Healthcare, often referred to as the city's super surgery, formed in October 2016 when the three practices merged.

But the merger has been dogged by problems with the phone lines, with many patients unable to get through to book appointments.

Although efforts have been made to tackle these issues, a national watchdog has now ruled that it is not up to scratch.

Inspectors from the Care Quality Commission visited Carlisle Healthcare in January this year and have now published their findings.

The practice received an overall rating of 'requires improvement'.

Though care itself was rated 'good', the practice was deemed 'inadequate' when it came to responding to patients' needs.

This was largely due to the problems faced by those trying to access services, particularly getting through on the practice phone lines and being able to get an appointment when needed.

Senior doctors admit that they have struggled, partly due to technology and partly due to staffing issues.

But they insist they have made improvements since the inspection, with further efforts now underway to bolster their workforce.

Many patients have questioned whether the three surgeries should have gone through with the merger - which saw the formation of the area's biggest practice, serving 36,000 patients.

However Dr Andrew Edgar, who was a GP at Brunswick House for 25 years prior to the merger, stressed that had they not, general practice in Carlisle would have potentially fallen into crisis.

"It was something we had to do to survive. To keep healthcare going for a third of Carlisle," he said.

"Otherwise... we do not know. We were certainly worried about what was going to happen. The doctors in Stanwix said they were very close to what happened in Whitehaven."

Dr Alan Edwards, a senior partner who had served with St Paul's for many years, described it as a "defensive merger".

"Was it the right thing to do? Yes. Was it perfect? No," he added.

Health chiefs have previously warned that general practice is facing significant problems across Cumbria.

There is a shortage of GPs across the county, and in the west vacancy rates are particularly high.

There are ongoing fears about the vulnerability of small practices like Whitehaven Medical Centre, which was run by just one GP.

Dr Edgar said that the closure of the practice has highlighted the potential consequences if action isn't taken.

"Whitehaven was a wake up call to all of us. The Stanwix practice wasn't far away from that," he said.

"It is hard to recruit GPs. We are constantly advertising. It's a constant battle, trying to increase clinical capacity."

He added that they are instead looking to employ more nurse practitioners, to help take pressure off doctors, and also want to take on paramedics, pharmacists and others with relevant skills.

Health leaders are working to allocate more than 4,000 patients with new practices ahead of the closure of a west Cumbrian surgery.

Two weeks ago Whitehaven Medical Centre announced it was to terminate its NHS contract at the end of the month.

The shock decision potentially meant 4,200 patients would have no GP.

But NHS England and NHS North Cumbria Clinical Commissioning Group (CCG) are currently working with other practices in the town to transfer all affected patients across to another surgery.

They have just a week left to complete this work, with the Whitehaven Medical Centre set to close permanently on July 31.

All patients should receive a letter informing them of their new practice ahead of this date. However, due to the high volume of patients affected, they will not be able to choose which one.