Mansfield doctor 'concerned for impact on A&E' as contractor ceases care

Central Nottinghamshire Clinical Services (CNCS), which provides out-of-hours GP services, urgent care and other primary services alongside the A&E department announced yesterday it was intending to go into administration.

And as the hospital battles to minimise the affect on patients, junior doctor Chris Episkopos warns that although the not-for-profit company only provides a portion of the hospital's service the crisis the Trust now faces may have an impact on other emergency care departments.

The representative for juniors amid a continuing dispute over doctors' contracts added: "What I'm most worried about is, if these services close, what kind of impact is that going to have on the acute services offered by the hospital?

"My impression is that the people working at PC24 do a huge amount to prevent hospital admissions and provide care to vulnerable people in the community.

"The A&E is already close to breaking point, and we barely have enough beds to admit everyone who needs inpatient care.

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"Primary Care 24 is a great idea, because it bridges the gap between nine-to-five GP care and 24/7 hospital emergency care.

"The biggest problem they have, and this is a problem shared by almost every out-of-hours primary care provider in the country, is that they don't have adequate resources. It's difficult to attract good GPs to come and work there out of hours, so a lot of the medical staff tend to be people who may not be well qualified for the job.

"I just don't see a way in which you can provide a service like that within a shoestring budget without cutting corners. The truth is, I don't know if it'll have an effect. If, as the Trust and CCG say, they'll find a way to continue providing that service, then maybe it won't.

"It's worrying."

The controversial not-for-profit company is a major partner of King's Mill hospital, and was at the centre of national criticism when the Care Quality Commission (CQC) rated the company's primary care services in Kirkby as 'inadequate', with reports of one GP on call for a million patients.

Now the local NHS commissioning group says it has been informed the contractor 'can no longer continue to provide the local health services' and it intends to file for administration.

The firm, a social enterprise formed just over a decade ago, provided include primary care out of hours, some urgent care and walk-in services, care home support services and carer support services.

NHS Mansfield & Ashfield CCG said they were re-assuring patients that urgent care services were still in safe hands.

A spokesman said: "CNCS has notified commissioners that they can no longer continue to provide the local health services they delivered in parts of Nottinghamshire and Leicestershire. CNCS has notified of its intention to go into administration.

"CNCS has experienced a number of financial and quality challenges over the last year. Commissioners have been working with CNCS since being notified of their intention to cease operating and has already put in place strong providers who will continue to provide services for the public. Patients who need to access care should not see any change in the availability of services."

Dr Amanda Sullivan, chief officer for NHS Mansfield and Ashfield CCG, who manage the contract with CNCS said: “As commissioners it is the CCG’s priority to ensure that continuity of the out-of-hours and urgent care services are maintained for the populations of Mansfield and Ashfield, Newark and Sherwood and Leicester, Leicestershire and Rutland. We appreciate the concern this has caused to staff and some patients but we have taken swift and decisive action.

“We wish to reassure staff, contractors and stakeholders that the CCGs have put in place alternative arrangements with experienced providers to ensure that those services remain accessible to the public as they do now. We value the contribution of the staff who continue to work tirelessly to deliver quality out of hours services.

“The new providers will start to take over the running of the existing service from 6.30pm on Thursday May12. All services will have transferred by Friday 13th May. Managers have visited sites to meet with staff and contractors to ensure that services can continue to be delivered safely."

Portfolio holder for Health & Wellbeing at Ashfield District Council Jim Aspinall said: "I had previously expressed my concerns about this company to the CCG, so for me this is not unexpected.

The CCG assure me those services will not suffer, I will be asking questions at our meeting on Monday with the CCG, about continuity of service and the employment status of the staff involved."

A partner of CNCS who provides care services at home said their concern was that numerous outpatients would be left without services.

Scott Marsh, Chief Executive of Respectful Care, which provides some agency staffing for the Rapid Intervention Team and Pathways, both organizations run by CNCS, said: "We just found out with no notice that our partnership with CNCS has just gone into administration today."We've had a couple of staff working in their organisation for the last six months on various areas of the business, delivering care to vulnerable adults and working with their emergency care team.”

"I'm worried about the standard of care as they're leaving vulnerable adults on their own. The Health & Social Care industry in Mansfield & Ashfield has worked tirelessly to improve all the services it’s provides. I hope the public can see that there are passionate companies out there who want to make Mansfield & Ashfield a better and safer place.

"We've now got to cut our ties with the company after we've made connections with them and we've got to break away our services now. It's going to leave vulnerable adults alone today and that’s not acceptable”.

"It's been very badly mismanaged and the board at CNCS should be ashamed," he added. "Last year they were a multi-million pound business and this year the administrators have been called in."

A spokesperson for CNCS said in a statement: “CNCS is working with its advisors and commissioners to ensure that service continuity will be maintained through the transfer of service delivery to other experienced care taker providers.”

The caretaker providers are:

- For out of hours urgent care services at PC24 at King’s Mill Hospital and the out of hours GP services at Newark Hospital - NEMS (Nottingham Emergency Medical Services)

- Care Home support services in Nottinghamshire – Nottinghamshire Healthcare NHS Trust

- Out of hours services in Leicester, Leicestershire and Rutland as well as the Loughborough Urgent Care Centre – Derbyshire Health United

"The CCGs are working closely with the providers to make sure that there is a smooth transition between the different organisations so staff are able to continue to carry out their duties and continue to deliver a quality service to patients,” added the local commissioning group.

Telephone numbers previously used to access out of hours services remain unchanged.