WHAT I LEARNED WHEN
MY PRACTICE FAILED:
DR HOLLY HARDY
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“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
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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).
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