Together with ‘true-up’ charges, the total charges demanded rose from £5556 to £34657 in just two years (a 560 per cent increase), and could top £40k this year.

At the same time the actual service provided has deteriorated. The Centre was without hot water for 3 months until earlier this month, as NHS PS failed to replace the boiler.

The practice is disputing all charges since 2016-17.
The practice has been attempting to negotiate with NHS PS but they have refused to reduce the charges to a reasonable level.

I have brought the matter to Health Scrutiny to ask them to investigate.

I have discovered that the BMA said earlier this year: ‘‘GP leaders have been warning since 2016 that huge extra costs imposed through service charge hikes could force practices to close if they were not reversed.’

I am worried that unless this issue is resolved, the 4000 people in Colyton, Colyford and surrounding rural area could lose the health centre which they rely on.

PAPER FOR DISCUSSION:

NHS Property Services and Colyton Health Centre

Colyton Health Centre is the only GP facility serving the town of Colyton and the surrounding rural area. Seaton and Colyton Medical Practice runs a busy branch surgery in the centre, with a GP and a nurse there all day Monday to Friday. The area has a growing and ageing population, with around 40 per cent over age 65. The Centre is located close to the heart of the town, within walking distance for most of its population.

The Centre maintenance charges

The Centre is a small, single storey building dating from 1960s which the Practice rents from NHS Property Services. The practice pays rent, together with 63 per cent of the costs of running the building.

For many years, these costs to the practice were around £4-5k p.a., reaching £5.5k in 2015-16, the final year with North Devon NHS Trust were landlords. However after NHS Property Services took over ownership of the property in 2016, they escalated enormously. The final figure for the current year, including ‘true-up’, could be as much as £40,000.

[Table here reproduced by photograph]

Service inadequacies

On top of this, the services the practice receives have deteriorated. NHS Property Services contract out the maintenance of the property to Mitie, and there have many examples of when jobs have been badly managed, the problem has been exacerbated rather than fixed, or the jobs have just not been carried out at all.

The Practice Manager states: ‘When preparing for a recent CQC inspection, we had to stick the floor in the nurses’ room down with duct tape as our request to replace it made 5 months previously had not been actioned.

We also discovered that basic fire checks had not been carried out. I have recently been approached by contractors wishing to carry out electrical work requested in 2016 but never actioned, the grass went uncut for most of the summer and in June the boiler was condemned so we have had no hot water or means to heat the building since then.’

The boiler was finally replaced last week but this has only uncovered more problems and the centre remains without hot water after more than 3 months.

Inappropriate charges

The practice has been attempting to negotiate with their landlords for over a year, and from information NHS Property Services have sent in the course of these negotiations they have realised that what they are being billed for is inaccurate.

They are charged over £2,500 per year for grounds maintenance including watering and maintaining of containers (they don’t have any), 4 hours of grass cutting every 2 weeks (they had a wild flower meadow in front of the surgery by July and since then contractors have been twice, each time for about 40 minutes) and fortnightly litter pick-ups (they have never seen anyone picking up litter.)
They have also been charged for the fitting of bed alarms for patients, but there are no beds in Colyton Health Centre (or anywhere else in the Axe Valley).

The unresolved issues

Charges for 2016-17 and 2017-18 remain in dispute, while the company has not yet provided a final figure for 2018-19.

After over a year of negotiations, the Practice has been unable to resolve these amounts or to persuade the company to agree a level of ongoing maintenance charges which would be appropriate to this small building.

The Practice Manager states: ‘We have spent an enormous amount of time as a practice attempting to achieve an acceptable solution which is fair and reflects the work carried out on the building, but so far to no avail. The maintenance is poor and impacts on staff and patients, while the astronomical rise in maintenance charges means we have to seriously consider the financial viability of continuing to operate from this site, something we definitely wish to do.’

Our requests to the Scrutiny Committee

I have brought this to the Committee because the Seaton and Colyton Medical Practice has been unsuccessful over an extended period of time in negotiating a reasonable level of charges and adequate delivery of the maintenance service.

They now feel it is appropriate that there should be public scrutiny of this situation, stating:

‘We appreciate your time in allowing us to bring this matter to your attention, and we would welcome the support of the committee in our attempt to resolve these issues in a satisfactory manner, which will allow us to focus on delivering healthcare to the people of Colyton and the surrounding area.’

As the County Councillor for Seaton and Colyton, representing not only the Practice but also the thousands of patients whom it serves, I hope the Committee will express its concern to NHS Property Services about this situation.

I also believe that the Committee should consider whether the way in which NHS Property Services has treated this practice raises issues about how the company manages properties across Devon.