• Sixteen out of 26 practices that make up Warrington CCG have lost confidence in its leadership
  • Leaked letter follows dismissal of elected representative which GPs say was “unjust”
  • CCG says appropriate governance processes were followed and it retains support from other practices

More than half the GP practices in Warrington have told the local clinical commissioning group they have “lost all confidence” in its leadership, HSJ has learnt.

In a letter to the accountable officer, the partners of 16 of 26 practices that make up Warrington CCG said the loss of confidence followed the “unjust dismissal” of an elected GP representative from the governing body.

It alleges there have been “disappointing behaviours” from accountable officer Dr Andrew Davies and chair Dr Dan Bunstone over the course of the last year, and says that a further two of the four GP representatives on the governing body have recently resigned.

The letter, which was leaked to HSJ, has also been copied to NHS England, as well as the local council and acute trust.

It added: “Based on a series of incidents and allegations over the past year within the CCG that have been inappropriate and unbecoming of clinical leadership, we are disappointed to say that we have lost all confidence in the current leadership of the non-elected GP chair as well as in yourself as the accountable officer for the CCG.”

In a statement, the CCG said appropriate governance processes had been followed in removing the GP from the governing body. They said he was involved in a new GP provider company for Warrington and there was a “conflict of interest issue”.

It added that a number of GPs from the remaining 10 practices have expressed their disagreement with the contents of the letter, and support for the CCG.

In 2014, Warrington was seen as a promising area of primary care transformation and was awarded £4.4m of national funding. But there have since been growing frictions between the CCG, GPs, and new provider organisations, including around the use of that money.

An initial GP provider company, Warrington Health Plus, was set up to manage the national funding but failed to gain widespread support, and some GPs have subsequently set up a separate company.

The GP removed from the governing body was Dr Michihiro Tomonaga, of Helsby Street Medical Centre. HSJ has also seen a letter from him to NHS England which makes a series of allegations against the CCG’s leaders.

In its statement, the CCG also pointed to the “good” rating it had recently received from NHS England, and added: “Clearly we are very disappointed by this, especially given that no issues have been raised through the internal formal channels with regards to the roles of both Dr Davies and Dr Bunstone.

“Whilst we are disappointed, looking forward we would like to meet with all our GP members, especially those who have endorsed the letter so we understand what the issues are and are able to address them.”

Dr Tomonaga told HSJ his complaint letter was now being considered by NHS England so did not wish to comment prior to those enquiries being completed.