Doctors tell patients they've run out of space amid potential Shrewsbury health hub move

The Shrewsbury Health and Wellbeing Hub, which would involve six surgeries closing and moving to a new site in Meole Brace, has been met with criticism and concerns over transport links and accessibility.

Now GPs from Marden Medical Practice in Sutton Road - one of the six practices that would move if the proposals receive the green light - have written to patients, telling them they are looking to move as their building is "no longer adequate".

They said: "Our current premises is a former detached house which was built almost 100 years ago. Over the last 30 years it has been extended and modified multiple times but is no longer adequate for the needs of our patients or staff. We are not allowed to stop accepting new patients (unlike dentists) and our practice population has expanded over the last 10 years from approximately 6,500 to almost 10,000.

"We are struggling to provide enough appointments for you because we don’t have enough rooms. We cannot recruit any additional clinical or administrative staff because we do not have enough space for them to work from and the space we do have is not suitable for our needs. Not all clinical rooms have central heating. We do not have capacity to provide accessible adult change facilities. There is no lift so our reception and admin staff must climb steep stairs and work from former first and second floor bedrooms which did not provide adequate space for them to maintain safe distancing during the Covid-19 pandemic. We have juggled space for years and have now reached capacity."

They added: "The proposed new building would be owned by the local NHS and the space would be shared between all practices, as well as other external services chosen according to the needs of the local community. This model of ownership would allow us to focus solely on continuing to provide outstanding care for our patients, rather than also managing premises problems. It would help us attract new GPs to work as part of a wider network of health and social care providers, in a modern, fit-for-purpose building. Potential new GP partners would not have to take on personal financial liability to lease or buy into their own building as they do now. This could have a huge positive impact on attracting newly qualified GPs into permanent positions at the practice, rather than working as locums.

"We know that some patients are worried about losing contact with their GP. Please can we reassure you that the practices that are looking to relocate to the hub would continue to function as independent practices. Marden Medical Practice has worked very hard to provide outstanding care for our patients and we absolutely want to retain our individuality. This is very important to us. The proposed move into the hub would NOT be a merger. It would still be our team of receptionists answering our phones, dealing with your queries and booking you appointments to see Marden clinicians. We would have clearly defined and separate Marden Medical Practice space within the building.

"We know that transport is a concern for lots of our patients, as it is for us too. It is imperative to us that accessibility issues will not discriminate against any of our patients receiving excellent care. We understand that the project team is working with Shropshire Council to provide a solution to public transport requirements and the traffic issues in Meole Brace. We are seeking reassurances about free parking for patients and staff. We would urge you to raise these issues during the consultation if they might affect you.

"We believe that the proposed Shrewsbury Health and Well-being Hub could provide Marden Medical Practice with a future proof home, with a team of dedicated and permanent clinicians working within a community-facing and community-activating environment that is filled with energy, life and opportunity."

The proposals have attracted criticism from councillors and campaigners, who have held protests. But health bosses insist it would represent a significant investment in GP services in the town.

The outline business case is expected to be submitted to NHS England this autumn/winter, and a public consultation will follow shortly after.

The letter in full:

You will no doubt be aware of the proposal for our involvement in a Shrewsbury Health & Wellbeing Hub, and some of the local media responses around this. We wanted to try and contact as many of our patients as possible to offer some reassurance and to answer some of the questions you may have.

We would like to first highlight that the hub is still a proposal. The outline business case hasn’t been submitted to NHS England yet and a public consultation hasn’t been carried out. This will happen later this year in the Autumn/Winter and we would encourage as many of our patients as possible to participate in this.

We are one of the practices looking at moving into the Hub because our building is no longer adequate for us to run our service out of. Our current premises is a former detached house which was built almost 100 years ago. Over the last 30 years it has been extended and modified multiple times but is no longer adequate for the needs of our patients or staff. We are not allowed to stop accepting new patients (unlike dentists) and our practice population has expanded over the last 10 years from approximately 6,500 to almost 10,000. We are struggling to provide enough appointments for you because we don’t have enough rooms. We cannot recruit any additional clinical or administrative staff because we do not have enough space for them to work from and the space we do have is not suitable for our needs. Not all clinical rooms have central heating. We do not have capacity to provide accessible adult change facilities. There is no lift so our reception and admin staff must climb steep stairs and work from former first and second floor bedrooms which did not provide adequate space for them to maintain safe distancing during the COVID-19 pandemic. We have juggled space for years and have now reached capacity.

The most logical solution to this problem may appear to be to extend our existing premises further, but even if our Landlords would grant us permission to do this, there is no funding available for individual practice developments available from NHS England. The funding for the proposed Hub is available because it is a pilot project, of which there are 5 others around the country. Shrewsbury is fortunate to have been successful in a bid to become one of them. We cannot choose to spend this funding in any other way.

The proposed new building would be owned by the local NHS (the ICB1) and the space would be shared between all practices, as well as other external services chosen according to the needs of the local community. This model of ownership would allow us to focus solely on continuing to provide outstanding care for our patients, rather than also managing premises problems. It would help us attract new GPs to work as part of a wider network of health and social care providers, in a modern, fit-forpurpose building. Potential new GP partners would not have to take on personal financial liability to lease or buy into their own building as they do now. This could have a huge positive impact on attracting newly qualified GPs into permanent positions at the practice, rather than working as locums.

We know that some patients are worried about losing contact with their GP. Please can we reassure you that the practices that are looking to relocate to the hub would continue to function as independent practices. Marden Medical Practice has worked very hard to provide outstanding care for our patients and we absolutely want to retain our individuality. This is very important to us. The proposed move into the hub would NOT be a merger. It would still be our team of receptionists answering our phones, dealing with your queries and booking you appointments to see Marden clinicians. We would have clearly defined and separate Marden Medical Practice space within the building.

Alongside the separate space allocated to individual practices, there would also be some shared space to enable services currently provided by our Primary Care Network such as First Contact Practitioners, Social Prescribers and Pharmacists. As well as other services from health and social care such as Community Midwifery and Health Visitors, District Nurses, Phlebotomy and Xray to name but a few of the possibilities.

We know that transport is a concern for lots of our patients, as it is for us too. It is imperative to us that accessibility issues will not discriminate against any of our patients receiving excellent care. We understand that the project team is working with Shropshire Council to provide a solution to public transport requirements and the traffic issues in Meole Brace. We are seeking reassurances about free parking for patients and staff. We would urge you to raise these issues during the consultation if they might affect you.

The next steps are that we wait for the outcome of the public consultation and to see if NHS England will approve the funding or not. We will continue to have input into the proposed design for the building to ensure that is it going to meet both our patients needs and the needs of our team. Marden Medical Practice and all other practices looking to relocate are struggling in our current buildings. Primary care is struggling to recruit because young GPs don’t want to take on a lease or mortgage that is bigger than that which they pay for their own home.

We know that there will be challenges and teething problems, but we believe that the proposed hub would give us all an opportunity to continue to work together, to provide the high standard of primary care that you deserve and to improve your general health and wellbeing.

We believe that the proposed Shrewsbury Health and Well-being Hub could provide Marden Medical Practice with a future proof home, with a team of dedicated and permanent clinicians working within a community-facing and community-activating environment that is filled with energy, life and opportunity.