Boxford Surgery Proposal

 

We would like to thank you all our patients who participated in the patient engagement on the closure of our branch surgery at Boxford.  The engagement exercise has now closed and we are no longer taking feedback.

We will now be submitting all feedback received to the Integrated Care Board who will evaluate this and seek further validation from the practice where further assurance and compliance is needed.

Please see our Questions & Answers section below

What is the ICB?

An Integrated Care Board (ICB) is an NHS organisation that plans and buys healthcare services for our population. This function is commonly referred to as ‘commissioning’.  

The Hadleigh Boxford Group Practice falls within the Suffolk and North East Essex boundary.

For more information please see About Us - NHS Suffolk and North East Essex ICB.

Why are the ICB the final decision makers?

The Hadleigh Boxford Group Practice hold a contract with the ICB.

The practice is proposing a contractual change (operating from two business premises to one) and the ICB as the other party to that contract has to agree with the proposal in order for it to be legally binding. This ultimately makes the ICB the final decision makers.

Can we communicate our concerns directly to the ICB?

As part of the business case application to close the Boxford branch surgery, the Hadleigh Boxford Group Practice must lead on all patient engagement.

The practice must record all feedback/concerns received and submit them to the ICB at the end of the engagement period.

The dedicated team within the ICB will evaluate all feedback and analyse the practice responses seeking validation where further assurance and compliance is needed.  

Please refer to the practice on how to feedback your concerns to them.

Why are we making this application?

The current building at Boxford does not meet modern standards. To sustain a service at Boxford and make the building fit for purpose would involve extensive work on every aspect of the premises, which we cannot afford. There is also the high financial commitment needed from the Practice to maintain a service at Boxford.

Whilst we acknowledge the concerns a number of patients will experience when the branch surgery closes, the service offered at Hadleigh is considerably more comprehensive, effective, safer and efficient for the Practice and patients.

What will happen to the appointments at Boxford?

These will be offered from Hadleigh. We currently only provide a limited service at Boxford for all our patients with four basic GP sessions and two blood clinics each week.  

What will happen to my prescription which I collect from the Boxford dispensary?

Your medication will be available to collect from our Hadleigh dispensary.  Our Hadleigh surgery is open from 8am to 6:30pm weekdays.

We are also currently negotiating the installation of a 24 hour collection machine at Hadleigh.  Patients can also choose to use either a local or an online pharmacy.

Boxford village is expanding. Has this been considered in the decision to make this application?

Our Practice list is increasing overall, our current list size is 16163 (30/06/24).  55% of our patients live in Hadleigh, 45% live in villages outside of Hadleigh, with 9% of these living in Boxford.

More houses are being built in the area in Hadleigh and the local villages. With this in mind we are able to offer the service to all our patients from Hadleigh and we have the facilities in this building to increase services in line with the need of our list size if required.  We monitor this closely.  

If funding was available to improve or relocate the Boxford building, would the Practice consider this?

In our decision to apply for Boxford closure we have looked at the limited service we provide there and the appointment data.  As such we note that patients will travel to either surgery to see the GP of their choice or where they can obtain an appointment on that day.  

Hadleigh provides a fully comprehensive service that is available for all our patients.  We believe operating a limited service at a branch surgery which all our patients can currently use is not a cost-effective use of our NHS budget.

Have you considered keeping the Dispensary at Boxford?

A dispensary must have a GP present for a substantial portion of its operating hours.  It is not therefore possible to retain the present dispensing capability without such support and this would not be cost effective given the percentage of patients in Boxford and the surrounding villages.

What facilities does Hadleigh offer which are not available at Boxford?

We have 13 Doctors working at Hadleigh, only 4 of whom work part-time at Boxford.  We will therefore be able to offer you an appointment from a larger group of Doctors.

Other specialists are also available for appointments at Hadleigh which include Nurse Practitioners, Practice Nurses, Pharmacists, Midwife, Physiotherapist and a Mental Health Link Worker. We also offer specialised clinics for minor operations, coils, childhood vaccinations, cytology and long-term condition clinics.

I do not have transport and worried about getting to Hadleigh

We are aware that some patients do not have transport. Local volunteer groups are willing and able to help with transport issues to and from the Practice.

We will also do our best to be flexible with our appointments so that patients can obtain a lift or use the local bus.  In some cases a telephone consultation is appropriate thus avoiding the need to travel to Hadleigh. Patients can request these when they call to make an appointment. 

I am concerned about parking at Hadleigh

We are aware our car park does get quite full.  However, there are several council car parks not far from the Practice. 

 
 

Feeback so far

Have you already made your minds up?

The practice has made the application to close our Boxford branch surgery.  

The final decision is not up to us ultimately, the decision is made by the NHS Suffolk and North East Essex Integrated Care Board (ICB) and Primary Care Commissioning Group which will look at all of the evidence from the patient engagement. 

If you do not have internet access, how can you order your prescriptions

Some of the online pharmacies allow patients to telephone to order their repeat. You can also post us your repeat slip.  

The NHS has a list of online pharmacies here.

Will it be harder to get an appointment at Hadleigh?

No, the number of appointments at Hadleigh will be increasing to compensate for what is being lost in Boxford. There will not be a reduction in appointments overall.  

There is no change to the way appointments are booked.  

Patients can also use eConsult to consult with us.

I don't drive, how am I going to get to Hadleigh?

This is the case for 45% of our patients who live in villages around Hadleigh. Options include asking a friend or relative to give you a lift, travelling on the bus or taking a taxi. There is also a voluntary car service.  You can ask for a telephone consultation or eConsult.  We also know that Boxford patients are already having appointments in our Hadleigh surgery and some patients living in Boxford are not registered at our Practice.

Will this increase the pressure on home visits?

We are only able to offer home visits to patients who are housebound due to their health conditions. This number is not expected to change. 

I work full time, how can I collect my prescriptions?

Boxford dispensary has limited opening hours, closing by 4.30pm every day. The dispensary in Hadleigh is open until 6.30pm every weekday, and prescriptions can also be sent to any other pharmacy. We are in the final stages of procuring an out-of-hours medication vending machine which, once up and running, will allow patients to collect medication 24 hours a day 7 days a week.

Patients can choose to nominate any pharmacy they wish and this can include one nearer to where you work.

Why is the building not fit for purpose?

The building is not equipped for patients in wheelchairs, the building has extensive issues with the drains, which are permanently blocked and staff working with sewage smell at times.  Whilst we have funded on-going maintenance costs, the building still needs further work including rewiring, new windows, new electric heating, improved infection control facilities and a complete uplift internally but this will only address some of the issues and not the larger issues with the building layout which makes it unsuitable for some of our patients with a disability.  

We also view the investment in this building not a cost effective use of our NHS budget when we are running only a part service for our patients.  We have also considered the on-going running costs of this building which could fund additional clinical sessions.  

If there was funding available to improve Boxford, for example crowd funding or community levy funding would the practice consider keeping it open?

Unfortunately not, to improve the building to make it better for disabled patients and safer it would require losing clinical space, therefore reduce consulting rooms and this still would not improve the fire access issue. 

Additionally there would still be on-going running costs to keep the branch open.  We consider this not a good use of our budget when we have better facilities and more services at Hadleigh, the aim is to consolidate our service from one site available for all our 16100 patients. We also know that the Boxford appointments, as many as 50% of them are being booked by non-Boxford patients, even from patients living in Hadleigh.   

Boxford has a predominately an elderly population, this is going to leave a large group of patients vulnerable.

Our data does not support this, we have 1466 patients who live in the Boxford village, this includes patients who have a Boxford postcode but still not walking distance to the surgery, out of this group we have 212 over 76 (01/09/24).

Age / Patient Number:

  • Under 18 / 126
  • 18-65 / 955
  • 66-75 / 173
  • 76 and over / 212

Hadleigh surgery is very busy and this will put additional pressure on the service there.

We have considered this in our decision to apply.  We are looking at ways to help with this, for example the medicine machine, appointment times and reducing unnecessary face to face appointments when a telephone call works equally as well, an example of this is some basic medication reviews.   

How come the practice spent money on refurbishing Hadleigh and their dispensary and not Boxford?

Unlike Boxford, the Hadleigh surgery building is not owned but privately leased.  All recent work was funded by the landlord as part of our lease renewal. None of our NHS budget was spent on this work.

Is the surgery able to extend Hadleigh?

Potentially yes, we are in discussion with the landlord about additional space, any increase would need to be approved by the ICB.

It is often difficult to get an online appointment.

We are working on this, we understand these appointments are often taken as soon as they are released. We are looking at the distribution of these and how we can approve this.  

It is important to understand that there will be the same number of appointment overall if Boxford does close.  

I find it easier to go into Boxford to make an appointment rather than being triaged by a Hadleigh receptionist.

The Care Navigation team at Hadleigh do not triage but signpost and to do this they need to ascertain the reason for the call. Since covid we have seen a rise of 30% uptake in demand for appointments and it is now more important for us to understand the reason for the appointment.  

We are still seeing a large number of patients who do not attend on a daily basis.

Parking at Hadleigh is difficult and I am concerned about car park charges.

There are four public car parks in Hadleigh all relatively close to the surgery. The surgery does also have its own car park.  

The difficulties with parking and charging is faced by all our patients including those who live in Hadleigh but are too frail to walk.  

I am concerned about using the Hadleigh waiting room because of the risk of infection.

The additional patients in the waiting room equates to approximately one every ten minutes. Patients can take responsibility to reduce this risk, for example ensure good hand hygiene and if concerned wear a mask.  

Have you considered the environment with more cars travelling to Hadleigh?

We have considered this, we already know that during a morning surgery at Boxford, many patients are travelling from Hadleigh, this would reduce and so we consider this an important factor when looking at the enverimontal issues.

Appointments missed or late due to poor bus service, will you still the patient if this happens?

We encourage our patients to call us in the first instance in these circumstances.  We will always do our best to accommodate all our patients if they arrive late or have issues with transport and we will endeavour to try and fit patients in whenever possible.  However, we cannot guarantee this can always happen and it very much depends on the clinician, whether they are already running behind schedule, have on-call duties or other clinical commitments that cannot be changed.

Access to appointments, will there be flexibility to allow transport dependant on the availability of when this can be provided?

We are currently looking at this within the practice to see if we can make provision to allow appointments to coincide with bus times.  We will always try to be as flexible as we can to support patients who rely on transport but there may be times that we cannot do this on the day, in these circumstances we may have to offer an alternative day or time or another clinician.    

What is plan B if your application is declined?

Discussions will take place with our local ICB about the way forward and they will advise on this.

Can you provide a mobile service for prescriptions?

Unfortunately we will not be able to provide a delivery service for prescriptions.  However, we have systems in place in other villages where they have a designated named person who collects a group of patients' prescriptions on their behalf.

You mentioned a 24/7 vending machine for the collection of medication, why can this not be placed in Boxford?

The machine needs to be located next to our dispensary where are drugs are stored and it can be regularly accessed throughout the day to install the prescriptions.  It would not be practical to locate this in Boxford. 

What will happen to the staff at Boxford?

All our dispensing staff working at Boxford will work all their hours at Hadleigh. The clinical staff will move their clinics to Hadleigh.

Can lots of prescriptions be dropped off at a central location in the village for patients to collect from there?

We are exploring options whether we can offer a collection point in Boxford and this maybe a possibility but we need to more time to see if this option is viable and/or would be approved under our dispensing contract

Why was the meeting held at that time of day and not in the evening, and why was it not open to more people?

We asked our patients to feedback to us via a number of different routes, online, email, a form in the waiting room and by letter.  Additionally we offered one event in the village hall as another route to feedback.  The meeting was open to anyone that wished to attend. We never restricted this to a maximum number of patient attendees. As this meeting was to focus on the proposed Boxford closure, it seemed logical the meeting was held at a time that Boxford would be open seeing patients. The reasoning was that if patients are normally busy at this time (for example at work), then that group of patients would not be using Boxford surgery as this has limited opening times compared to Hadleigh. 

Published: Oct 31, 2024