Best Practice issue 9 | Page 16

WHAT I LEARNED WHEN MY PRACTICE FAILED: DR HOLLY HARDY Now only 400 complimentary passes remaining - Register now! www.bestpracticeshow.co.uk 0207 348 4906 r.kilmartin@closerstillmedia.com “It’s very lonely being a GP partner when things go wrong”, says Dr Ho lly Hardy, reflecting on a life-changing decision to resign her GMS contract Dr Holly Hardy, GP, Health Education South West, will be speaking at Best Practice Dr Hardy found there was very little support when her small Bristol practice became unviable after two partners took early retirement within 18 months of each other. She and the remaining part-time GP were unable to recruit permanent staff to replace the partners and this left them working additional sessions, often until midnight and using locum cover to maintain cover for their 6000 patients and to try to save the jobs of their 12 staff, which were at risk. back her GMS contract to acceptance, feeling more positive about the future and having lessons to share. flexibly or at a different pace. Federating and merging with nearby practices are also part of the solution. She passionately believes there is a future for general practice but in order to survive she says GPs should consider sharing more of their workload with other healthcare professionals such as pharmacists and nurse practitioners. She also feels that more incentives should be offered to GPs coming up to retirement to encourage them to stay on and work Dr Hardy is currently working part time as a salaried GP in her practice and for Health Education South West. She has recently been voted on to the Council of the Royal College of GPs. She will be sharing her experiences in the Big Grassroots Panel Debate at Best Practice. They approached NHS England, the local medical committee (LMC) and neighbouring practices for help, exploring the idea of a merger or of joining a federation. However, they could not reach a solution. Local practices could not help because of their own rising workloads. After nine months, and knowing that they could not continue to work safely, they took the difficult decision to resign. The practice has been temporarily taken over on a 12 month contract by a larger practice from South Gloucestershire but a permanent solution for the patients has yet to be finalised. Dr Hardy says the financial side of making the decision to resign the contract was very scary because she and the other remaining partner would be liable for the redundancy costs if another organisation did not take over the contract. Potentially she could have lost her life savings or her house. Her property owning partners would became liable for the costs of redeeming the mortgage early. “The emotional side was also immense. Probably the worst thing of all was that I felt very guilty about the impact of the decision on both staff and patients. The stress also took a toll on my family,” she recalls. Now that a year has passed she feels she should have been more vociferous about the help she needed. “If I had my time again I would have been more assertive about what the options were, what financial and workforce support we needed. “Other people have contacted me from around the country saying they’re in a similar situation and I am saying to them: go to your LMC, go to NHS England and look at how you can make your practice work, how you can plug the gaps and what your longer term strategy might be. But it is difficult because there aren’t doctors growing on trees. “Working together is the key and having those conversations early when you realise things are going wrong. Don’t just keep struggling along on the hamster wheel. You need to shout very loudly and say - we need to do something now. I think we lost quite a bit of time at the beginning.” Dr Hardy says after a year she has moved from feeling angry about having no choice but to hand 16 Join the conversation @BestPracticeUK Understanding governance: turning a burden into a benefit By Justin Cumberlege, Head of Healthcare, Carter Lemon Camerons LLP Let’s start with some questions… • What does governance mean to you? • How do the roles of your federation members and directors differ? • How could a thought-through governance structure benefit your federation? • Are you aware that failing governance can result in anything from ineptitude to imprisonment? By forming federations, GPs can reduce costs, enhance efficiency and be better placed to take advantage of an evolving provider environment. 020 7406 1000 But many pitfalls await the unwary, particularly in relation to governance, the framework establishing who does what and when. Our Healthcare team regularly assists GP federations in setting up structures to embed robust governance, tailored to individual needs and goals, on establishment or by helping those who jumped in without looking to get back on track. Assignments include advising on the incorporation of a federation of 44 practices, with ownership based on patient numbers in each; assisting an eight practice group to amend its social enterprise company’s constitution; and setting up a company owned by the practices’ partners. There’s no one size fits all solution for federations. But seeking the advice of experts is the first step to making your federation fit for purpose. Justin will give an expert insight into creating successful federations at a Best Practice conference workshop at 11.30am on 22 October 2015. For more information, please contact us. JustinCumberlege@cartercamerons.com www.gphealthcarelaw.co.uk Carter Lemon Camerons Healthcare is a team at Carter Lemon Camerons LLP, Solicitors, a limited liability partnership registered in England and Wales with number OC333252. It is authorised and regulated by the Solicitors Regulation Authority (SRA 487190). www.bestpracticeshow.co.uk