A CONTROVERSIAL change to GP cover at community hospitals has won the support of an independent review – but it demanded doctors increase their hours.

A panel today backed letting one practice instead of local surgeries send GPs to Amersham, Marlow, Buckingham and Thame community hospitals.

Some residents raised concerns about the cut in cover hours and the breaking of the link between the hospitals and local GPs. Hours went from 10 to 15 at Marlow to eight.

A GP and a patients group hit out at the findings – and beds could now be cut under a new review of the hospitals.

The review, which needs health boss approval, found: “It was generally agreed that the service specification is right.”

Changes introduced by Community Health Buckinghamshire, a division of NHS Buckinghamshire, had not “had a detrimental impact on patient care and safety”.

Yet it said GPs from The Practice surgery must raise their hours from four, five or eight to up to eight, ten or 16.

Care is mostly provided by nurses as patients are mostly recovering and they needed more time to train to “reduce” doctor time.

It said of the original hours: “While this might be sufficient once the nurse-led model is fully developed, it was felt the hours needed to be re-negotiated for a temporary period.”

See the links at the bottom of this story for the full report and previous stories.

Asked by The Bucks Free Press whether this called into question the competence of CHB, review chairman David Lunn said: “We have said we think they were mistaken in going for those lower level of hours.”

And the review found a “failure to clearly understand” the previous arrangements, replaced on September 1 and a “failure to engage with GPs”. Closer links must be forged, it said.

The report also concluded: “Insufficient thought was given to the transition to a fully functioning, nurse-led model that would be capable of functioning with the level of medical cover provided [under the agreed option].”

No consultation took place and the report said CHB “regretted not engaging the community” in its decision. This was a “great pity” said Mr Lunn.

But the report concluded CHB was right not to ask a Buckinghamshire County Council health watchdog its view.

This is needed if changes are a “substantial variation” – but the report said GPs hours had not changed enough, as previous hours were for availability not actual work.

The report also said it would have been “preferable” that CHB ran the issue past NHSB board members, given its “sensitivity”.

A 4,000 signature petition opposed the plan and GPs from Thame warned patients were at risk.

Yet concerns over The Practice being a commercial organisations are “unfounded”, it said – as all practices are independent “profit making businesses”.

The cash-strapped trust did not make changes to cut costs, it said, though Mr Lunn said the new bid was “much lower” than the £400,000 old contract.

The report said the changes were introduced on September 1 as there was concern about different levels of cover at the hospitals and CHB had noted a “great improvement”.

Bosses at CHB said attempts to discuss this with practices “had not been successful” so it re-tendered. Reporting was better and there had been “few complaints or significant events”.

All 22 patients surveyed “reacted positively” while 18 staff thought new system same or better and 19 thought it worse.

GPs said care was good but had not yet had enough experience of it.

But The Marlow Medical Group’s Dr Chris North told the BFP: “I am disappointed that they have missed an opportunity to integrate services.”

At a private meeting yesterday he told bosses it was “somewhat premature” to change the contract when NHSB is about to review all its community hospitals.

John Wrigley, chairman of Buckingham Hospital League of Friends, said he had his doubts overturned after joining the review panel.

But LoF member Frank Donlon said: “I am disappointed with the panel’s view that it was not a sustentative change.

“I am worried GPs who lost the contract will be even more disengaged now.”