Westgate Response to Shenstone Residents Petition

We write with reference to the set of signatures received from the residents of Shenstone and the supporting letter from the local MP dated 15th October 2021, (received 29th October 2021) with regards to our Shenstone Branch Surgery.

Firstly, we would like to highlight that The Westgate Practice, Greenhill, Lichfield is the main practice site and as such all patients are registered with us at this main site. Shenstone Branch is not a separate practice provision however we do acknowledge that historically it has provided our patients with a choice of location, being particularly convenient for those living in the vicinity.

The Practice does sincerely appreciate your disappointment with our decision not to reopen the surgery until at least spring 2022 but there are very valid reasons as to why the branch remains closed to patients. We feel sure this decision does not substantially affect the quality of the service provision being offered to all our patients registered with the Westgate Practice.

The information below gives a summary of Westgate Practice’s current operating position and a brief history that provides the rationale for the current position regarding our Shenstone Branch.

In short, since March 2020, we have continued to review all our operations in line with national guidance and infection control advice. This includes the use of Westgate’s Shenstone branch. These reviews have been published regularly. The next review is due at our Partners Board meeting to be held on 8th November 2021.

In line with most GP practices across the country, we are currently offering around 20% more appointments than pre-pandemic levels (source: NHS Digital), taking around 10% more calls and providing access to services through a wider set of media options, as encouraged by successive Secretaries of State. An interesting finding has been a general patient preference for remote triage and consultation – our telephone appointments always fill up daily before the face-to-face ones.

In addition to the above, we have supported the delivery of in excess of 40,000 COVID vaccines.

At the start of the pandemic we reviewed and amended our operating procedures and reduced face to face contact prior to national lockdown measures. This was due to a rising number of sick people locally, severe staff shortages due to sickness and quarantine and no access to PPE or testing. The Shenstone Branch, at this stage, was used as a facility for people working from home (due the NHS IT systems at this point, we needed ‘slave’ P.C.s that staff could log into remotely). Without this component of service at the Shenstone site, we would not have been able to maintain a viable offering to all of our patients across Lichfield and the surrounding areas.

During the COVID pandemic we have continued to see our patients face to face at the Westgate Practice. Even during the early waves we continued to invite our patients for important treatments such as Blood tests, Smear tests, Baby immunisations and anticoagulation clinics. Throughout this time our patients have also been offered a face to face appointment with our GPs if this was deemed clinically necessary.

Our Shenstone Branch has remained open throughout the pandemic, principally as a telephone hub, and has been key to us being able to increase our appointment levels and telephone response in the face of significantly rising demand. Shenstone branch site has also provided a safe environment for those staff members who are extremely vulnerable who otherwise would not be able to work.

The Westgate Practice did hold one flu clinic this year at the Shenstone Branch. This was risk assessed, based on the operation for the ‘flu clinic’ being different to those that would be required to offer GP/Clinician appointments on a face to face basis. The appointment time for the Shenstone ‘flu clinic was only 3 minutes per person and therefore due to staggered arrival times there was very limited waiting for patients within the actual building and a quick flow through system with many support staff and clinicians on hand.  For standard routine 12 minute appointments however, Greenhill site is much larger and so provides for safe queue management, waiting space and an effective flow system.

Sickness and isolation levels remain high at the Practice and only last week we had a further 2 GPs taken sick. Our regular reviews of operations consider the balance of staff and patient safety and the impact of any change on the Westgate Practice ability to operate safely as a whole.

As an example of this difficult balance, we risk not being able to respond as well to extremely sick patients. All our resources for this are currently focussed at the Lichfield centre. Diluting this essential safety measure between Lichfield and Shenstone remains risky when the COVID rates in the Lichfield area remain high. In the past week alone the Practice has responded to a number of emergency situations where ambulance crews needed to be called, during which we had to wait up to 2 hours for them to arrive. This has meant a number of clinicians were needed on hand to support those patients whilst we wait. We firmly believe that patients access a higher level of care at the main Westgate site due to support staff being on hand that would not be available at the Branch surgery.

The impact of re-opening Shenstone Branch and the result of these factors above would be fewer phone calls answered and fewer appointments offered by the Practice.

We do have some options to help with these difficult choices but they will take time to materialise – hence the ongoing reviews. The use of Shenstone Branch remains a cornerstone of our pandemic response. We always take our patient feedback seriously; we have an active Patient Participation Group who have been updated regularly. The PPG have fed back their concerns on this and other issues.

As stated above, we keep our options open – our top priorities remain a continued high level of service and a safe place for our staff to work. The practice specifically notes and appreciates the frustration of Shenstone residents in the closure of the branch for this period of time. We sincerely thank you for your understanding and will of course keep you informed of any further decisions affecting the Shenstone branch surgery.