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A GP practice in the Midlands this week wrote a scathing 16-page letter to its patients, urging them to stop contacting the surgery unless absolutely necessary.

The letter, published by Ivy Grove Surgery in Derbyshire, criticised patients for “ignoring” medical advice, contacting their GP for minor symptoms and “avoiding” looking after themselves.

The practice raised important points regarding the need for improved communication to patients about how and when they can access the most suitable service for their problem — but the tone of the document has the potential to scare patients into not contacting their GP when discovering potentially serious symptoms.

GPs more widely have already raised concerns about the risks associated with remote consultations, such as important symptoms being missed during a phone appointment.

GPs have also spoken openly about the extreme pressures they are facing to tackle rising demand — which seems to have been partially brought on by the rise in online consultations — as well as the covid -19 vaccination programme.

The letter even stated: “Unfortunately due to the open availability of eConsult, and some limitations in how it is being implemented, our experience with it is that it has been like opening up a brand new lane on a full motorway that was already littered with roadworks and having an instant traffic jam as a result.”

Not tolerating further failures

Cygnet Health Care has cropped up regularly in stories about poor care within private mental health hospitals. And, each time a Care Quality Commission report is published or a scandal comes to light, the same question crops up — where are the commissioners and what are they doing about the poor services they are paying for?

But NHS England isn’t staying silent, writing to Cygnet with a warning that it “will not tolerate” further service failures.

HSJ has seen the letter and it’s strong stuff. If the NHSE has sent these warning letters before, they didn’t reach the public domain. 

The letter — which was apparently sent in reference specifically to the services NHSE commissions from Cygnet, which is around a dozen hospitals — warned NHSE would not hesitate to take further action.

But what that action could be is anyone’s guess — financial penalties, maybe? Closing beds feels unlikely as shutting down a dozen inpatient units would only exacerbate the already existing national scarcity of mental health beds.