On the afternoon of Tuesday 30^th July, NEECCG held a meeting of its Governing Body at which they decided to terminate the ACE contract for Caradoc surgery.  Sadly ACE was not informed directly of this decision and instead we found out via the local PPG. Official confirmation did not arrive until early evening on Wednesday 31^st July.

Obviously, we are shocked and disappointed, one for the manner in which we received the news and two, the reasons for the termination.  Some of the context behind our Caradoc service is detailed below.

What we absolutely acknowledge now is the need to provide a smooth and timely handover to the new service provider, Ranworth Surgery, ensuring that patient health and wellbeing is the top priority.

We are focusing our efforts on supporting those members of ACE’s staff affected during this swift transition.  The CCG has stipulated that the transfer must be completed by 31^st August 2019.  We will cooperate closely with the CCG, and with Ranworth, to meet this challenging timetable.

SOME IMPORTANT CONTEXT TO THE CCG’S DECISION

1 - We have undoubtedly encountered challenges in developing our new Care Navigation operating model across our four GP practices, one of which is Caradoc. However, we have seen significant and measurable improvements in quality and outcomes in the last 18 months, all of which the CCG has witnessed and endorsed.

2 - Somewhat perplexingly, the paper on ACE’s GP practices considered by NEECCG’s Governing Body in its public session did not, in fact, recommend the action the Body subsequently took. It recommended the continuation of collaborative work together, something ACE would, of course, have welcomed.  A selection of comments in that paper are as follows:

• “…improvements have been made in respect of QOF in the last 18 months”.
• “… the level of concerns and complaints in relation to access to the practices via the Hub still remains high, although have decreased in recent months.”
• “GP Primary Care Choice (GPPC) was commissioned by the CCG to complete a review of care navigation usage within the ACE hub… Over the course of the seven months it was noted that a number improvements had been made:..”
• “CCG colleagues had been suitably assured that PALS/complaints are recorded, monitored and responded to within an appropriate timescale.”
• “CCG colleagues acknowledge [ACE] staff are working very hard to address the challenges in the face of severe public concern.”
• “Audits from April – June 2019 indicate full compliance with the 5 day turnaround of repeat prescriptions.”
• NEECCG’s own Minutes of our June 2019 joint performance review meeting record the CCG saying that “… Caradoc appear to have significantly increased their year-end average achievement position from 2017/18. This indicates the concerted effort by ACE in this regard and the CCG look forward to seeing this position continue to improve across both contracts”

3 - Although never a reason on its own, and not one revealed publicly before by ACE, the financial context within which we have been operating highlights some of the grave pressures ACE has been dealing with in recent years, in that:

• When renewing our Caradoc contract in March 2016, NHS England reduced ACE’s funding by 28% from earlier years
• As a result of this, and further cuts when our ACE Community Practice contract was renewed by NHS England in March 2018, ACE’s funding for our four GP practices has been cut in total by 23% since 2015/16
• Amongst our own four practices, our Caradoc contract pays us 17p in the £ less (per Caradoc patient, after adjusting for need) than we receive for our three other practices