Some Bucks GPs to stop offering post-op wound care

Many of the practices served notice over summer that they would no longer provide the service, which includes cleaning, dressing and monitoring wounds.

The Buckinghamshire, Oxfordshire and West Berkshire Integrated Care Board (ICB) said that a total of 17 surgeries had informed it that they would no longer provide this care.

However, during a meeting of Buckinghamshire council’s health and adult social care select committee on Thursday, health bosses admitted that the true number was nearer to 30.

Councillors at the meeting grilled board members over the changes, which affect serious wounds following operations, rather than more simple procedures such as the removal of a couple of stitches.

Anna Marcus, the head of primary care integration at the ICB, told the meeting: “Post-operative wound care across the country is an issue that a lot of systems struggle with for a number of reasons. One of which is that it is not explicitly outlined in the GP contract.”

Marcus explained that in Buckinghamshire, GPs had historically provided the unfunded service out of ‘good will’ and that the wound care was not in the ICB’s contract, so it had not therefore ‘decommissioned any service’.

The ICB said the withdrawal of wound care by ‘overstretched’ GPs could have a ‘low imminent risk to patient safety and harm’.

Reasons put forward for GPs’ ending their ‘good will’ service include a lack of expertise within primary care nursing teams, the loss of a skilled workforce due to age and demographics, and the increasing demand on practices.

In response, the ICB has announced immediate mitigation measures including encouraging surgical teams to use ‘appropriate alternative dressings’, as well as ‘patient self-management’.

Beyond the short-term, the ICB said it was also working on a ‘sustainable long-term solution’, which could include the ‘development of dedicated clinics’ or ‘wound care hubs’.

During Thursday’s meeting, Cllr Robin Stuchbury asked members of the ICB how they were going to help resolve the ‘gap in service’ and what extra money could be found for GPs.

He said: “Your job as the board is to sort this out. Please can you give an answer as to how you are going to sort this out, what budget you are going to find.”

Rachel Corser, the chief nursing officer at the ICB responded by saying that the majority of patients were getting the post-operative wound care they needed and that she and her colleagues were working quickly to resolve the issue.

She also claimed that workforce issues were partly to blame for GPs withdrawing this service, rather than a lack of funding and so, ‘no matter how much money we throw at this, we haven’t got the people to support the service’.

During the meeting, health chiefs said that they technically did not have to provide a list of GPs no longer providing post-operative wound care and that it might not be helpful to do so anyway at this stage.

But committee chair, Cllr Matthew Walsh, urged them to show greater openness about the changes to the provision of some wound care.

He told the meeting: “There seems real reluctance on the part of your organisation to share with us the information about which surgeries are no longer providing this information.

“It is, from all of our members’ perspective, a little bit frustrating.”