"Sooner the management is changed the better"

Buckshaw Village Surgery has a different type of contract to nearly all other GP surgeries; an APMS contract which is what I believe you are referring to above.

Until 2016, this contract specified the surgery had to offer 82 GP Appointments per 1,000 patients.

However when the contract was renewed in October 2016 core funding was reduced by approximately 23% and simultaneously the number of appointments that had to be offered was reduced to 70 Clinical Appointments per weighted 1,000 patients.

This change of funding and reduction in the number of appointments was set by the local Clinical Commissioning Group (CCG) when they commissioned the new contract and would have been exactly the same, regardless of who won the competitive tendering process.

This was explained at the time and during public meetings with the surgery and NHS England.

Weighted patient list is a national formula which has been in use since 2004 and takes into consideration, along with other practice characteristics, individual patients' age, gender and health conditions and calculates a "weighted" count of patients according to need. This means that two practices with the same number of patients may have very different weighted patient numbers due to widely varying patient characteristics and health conditions, and as a result, these practices which may seem to be similar in terms of list size, could receive very different levels of funding.

At Buckshaw Village Surgery our weighted list is approximately 20% lower than the actual number of patients registered at the surgery.

Contractually we must retain an open list, we are not allowed to stop new patients registering if they live within the practice boundary.

The surgery has no control over this.

The surgery's boundary was set out in the 2016 procurement documents, it is a very large and inclusive boundary which covers large parts of Chorley and Leyland including a significant number of new developments, not just Buckshaw Village.

Included in this boundary are new housing developments on Euxton Lane, Astley Village, the A49 development and several smaller developments in the Whittle/Clayton areas.

The surgery has raised concerns about this several times with the local CCG, but unfortunately the surgery is not in control of these boundaries.

The difference between GP and Clinical appointments is GP appointments must be with a GP however a clinical appointment is any appointment with an independent prescribing Clinician which includes doctors as well as Nurse Clinicians, Nurse Practitioners or prescribing Pharmacists.

The surgery has always offered late night opening on a Monday and always volunteered to open at weekends, when funding was provided.

In September 2017 the Weekend Opening Service was withdrawn and this led to a loss of an additional 72 appointments a week.

The surgery has since re-opened in evenings and weekends, but again the funding has been drastically reduced, therefore the service that can be offered has been drastically reduced.

This is again something the surgery has always fought hard over and believes is an important part of access.

These changes, which the surgery have little control over, have led to proportionally fewer appointments being available at the surgery and whilst striving to offer a good level of access, including operating things like the walk in service, there is a limit to the appointments we are able to offer.

We will continue to look at innovative ways to work and how we can best deliver services best, but there are a lot of factors impacting the availability of appointments which the surgery has little control over.