Primary Healthcare Darlington is a new player on the North-East health scene. Two of its leading lights tell Health and Education Editor Barry Nelson why GPs believe unity is strength

THE fact that all 11 GP practices in Darlington have formed a limited company called Primary Healthcare Darlington might alarm some who fear the creeping privatisation of the NHS.

But Darlington GPs Dr Jenny Steel and Dr Chris Mathieson are quick to point out that the opposite is true - and the aim is to keep primary care health services within Darlington and part of the NHS – and ride out the increasing waves of competitive tendering.

“We set up this company to keep primary care services within the NHS and to stop big private providers from cherrypicking services,” says Dr Steel, who says GPs have always operated as small businesses contracted to provide services for the Health Service.

The setting up of Primary Care Darlington Limited last October reflected Darlington GPs fears that services currently provided by family doctors would be hoovered up by outside companies.

Alarm bells rang when the Warfarin monitoring service previously provided by individual GP practices was taken over by a combination of a private company and the local NHS hospital trust.

Dr Mathieson, a GP at the Neasham Road surgery and one of the directors of Primary Care Darlington (PCD), explained the logic behind the move.

“With more work being put out to tender we thought we would set up a federation of practices to share expertise, share staff and provide economies of scale and keep primary care services local,” said Dr Mathieson.

“The basic contract will always be there but we are concerned at the prospect of losing additional services such as contraception and sexual health which we think should be kept within primary care in Darlington.”

“We can now bid for contracts for all of the primary care services in Darlington,” said Dr Mathieson.

PCD works closely with NHS Darlington Clinical Commissioning Group (CCG), the GP-led group which purchases hospital health care for the residents of Darlington on behalf of the NHS and is also involved in jointly purchasing primary health care for the town with NHS England.

To avoid a potential conflict of interest, the governing body of the CCG also includes lay people and officials from NHS England.

Since PHD was set up last October it has successfully bid for a slice of the Prime Minister’s Challenge Fund, allowing it to run weekend clinics at the town’s Denmark Street surgery and an evening telephone advice service manned by a GP. The fund was set up to try to improve access to GPs.

The Saturday morning clinics, offering pre-bookable appointments, have proved very popular but Sunday clinics attracted such small numbers that they have been cancelled.

Staffing problems meant that ambitious plans to employ two doctors to provide a telephone advice line for seven evenings a week had to be scaled down to one doctor operating the advice line five days a week.

The fund has also involved sending two GPs into Darlington Memorial Hospital on Sundays between 11am to 4pm to improve the understanding of the challenges their hospital colleagues face - as well as supporting patient discharges.

The relative scarcity of GPs is a major concern for PCD and both Dr Mathieson and Dr Steel believe that ambitious plans by the last Government to offer patients access to a GP from 8am until 8pm seven days a week are undermined by the lack of family doctors.

“There is at least a 10 year time-lag to get more trained GPs into the NHS,” said Dr Steel, chief executive of PHD.

Dr Mathieson said the shortage is already so serious - with around one in five of current GPs leaving their posts in the next five years – that practices were “struggling to protect the core services.”

One of the major issues facing the town’s GPs is the huge increase in demand from patients, fuelled by a more consumerist attitude towards healthcare and PHD wants to counter this by urging Darlington residents to use the NHS more responsibly.

“We need to have more of a partnership between doctors and patients,” says Dr Steel.

“People have to realise that every unnecessary appointment to see your GP has a cost. The Darlington NHS pound can only be spent once. It can’t be spent on something else. We would ask people to treat the NHS with respect and not to abuse it.”