An Oldham GP practice has lost its contract to treat patients after years of spiralling problems including a fraudster manager who swiped £580,000 to feed her gambling habit.

On Friday 28 January, members of the borough’s clinical commissioning group (CCG), the body that runs general practice, told staff at Failsworth Group Practice it was terminating its contract – leaving 12,000 registered patients in limbo as they await a permanent switch to a new surgery.

It followed damning watchdog reports outlining major problems at the practice, including missed diagnoses which could mean more than 170 people were never diagnosed with potentially life-altering kidney disease.

Inspectors’ findings on the surgery were so bleak it was put into special measures and local councillors were left ‘shocked’ at the report.

These included a GP refusing to offer treatment to a child who had become very unwell on the premises, instead telling the youngster they needed to go to A&E, while staff were not properly recording key documentation, including ‘do not resuscitate’ orders.

Health chiefs stress that they don’t take the decision to close a GP practice lightly – it’s an action of last resort.

Simply being rated ‘inadequate’ by the Care Quality Commission (CQC) isn’t normally enough for a practice to lose its contract to treat patients.

For that to happen there have to have been serious contract breaches, a significant risk of harm, and leaders have to be convinced that the only way to protect people is for them to be treated elsewhere.

It is understood that the experience of some patients means that they are now considering taking legal action against Failsworth Group Practice.

And there are a number of further formal investigations which could be launched over additional serious issues at the surgery.

But surgery manager Dr Fareeha Saeed said she was ‘heartbroken and devastated’ at losing the CCG contract, claiming things at the surgery were ‘on the mend and heading in the right direction’.

The thousands of patients registered with Failsworth Group Practice will now be temporarily split between two other GP practices in the same building while CCG staff look for a long-term solution.

Pete Davis, a Labour councillor representing Failsworth West, has himself been a patient at the practice since he was a child.

He says he has had constituents coming up to him in shops and regularly phoning him and his colleagues to complain about their GP services, but even he found the results of the recent inspection ‘shocking’.

“The latest report is absolutely damning,” he said. “We’ve had meetings with them, the MPs had meetings with them and it hasn’t improved and it can’t keep happening.

“There was no other option. Health is priceless.”

Failsworth Group Practice, which is based out of the Keppel Building on Ashton Road West, has long had a troubled history in the borough.

It was first rated inadequate by the CQC in 2015, before inspectors upgraded it to ‘good’ in 2016 – which was subsequently supported by a follow up inspection in 2018.

However that same year partners at the surgery became concerned when they discovered they needed to take out a £25,000 overdraft in order to have enough cash to pay staff.

It was discovered that the manager, Karen Evans, had falsified patient records to divert nearly £600,000 of money earmarked for medication, staff wages and medical supplies to her two bank accounts over a 15 month period.

The then 44-year-old mother of two used most of the money to feed her gambling addiction, logging into online betting apps including Sky Bet, Gala Bingo and Bet Fred.

Evans was jailed for more than three years in 2019 for the fraud.

However following her actions, the practice, which was being run as a small business by partners, began to destabilise.

Four of the partners left as a direct result of Evans’ criminal activity, either taking new jobs or early retirement, leaving just one partner working at the surgery.

A routine CQC inspection in May 2021 downgraded the ‘good’ surgery once again to ‘requires improvement’, with the category of ‘well-led’ slammed as ‘inadequate’ and the watchdog finding four breaches of legal regulations.

They promised a re-inspection within six months, and councillors and the CCG pledged to work with the surgery to turn things around.

During the summer an NHS patient survey found that the practice finished bottom in the borough in terms of getting through on the phone with just 13 per cent finding it easy.

Local councillors and the Failsworth MP, Angela Rayner, were being assailed with complaints from residents struggling to access appointments or be seen by their GP.

And when the CQC inspection team came once again to the practice in early December things had not improved.

In fact they had become demonstratively worse.

The categories of safety, effectiveness, responsiveness and leadership of the surgery were all given the worst rating of ‘inadequate’.

Sources within the health system described the situation as ‘depressing’, with investment and support failing to help improve services.

The lack of medical staff to treat patients is considered a crucial factor in the loss of the practice contract.

With a patient list of more than 12,100, the CQC found there were four GPs and two healthcare assistants employed at the surgery, supported by locum doctors and practice nurses.

Staff told inspectors they felt under increased pressure and stress as a result, while the provider said they constantly tried to recruit new staff but it was ‘difficult to retain them’.

“The staff we spoke with told us they were not able to raise concerns in the practice without fear of retribution,” CQC inspectors said.

With a shortage of staff came other failings, both administratively and clinically.

A ‘serious event’ occurred at the practice sometime between the May and December inspections.

During a booked visit to the practice a child had become ‘very unwell’ while they were still on the premises and their parent had asked to see the GP again.

However the GP ‘would not see them, and they were told to attend A&E’, the report states.

A formal complaint was made to the practice following the incident.

But despite this it was not officially recorded as a ‘significant event’ until a week after the CQC interviewed the provider.

During the watchdog inspection, clinical record searches were undertaken by a GP specialist adviser, who examined the list of patients to identify those at risk of chronic kidney disease.

They found there were 172 with potentially undiagnosed chronic kidney disease (CKD).

The cases of five patients were investigated in detail and it was found that none had undergone a test that helps to identify kidney disease that can occur as a complication of diabetes.

“We identified that four of the five had stage three to five CKD and one was borderline,” the inspection report states.

“CKD was not recorded as being discussed in any of the patients’ notes. For two of the five patients there had been no follow-up when their blood pressure had been raised.”

Monitoring of patients taking high-risk medication was also sub-standard, the CQC said, with processes not put in place to ensure this was carried out – despite it having been raised as an issue in May last year.

Many patients were overdue for blood tests, and several ‘do not attempt cardio pulmonary resuscitation’ (DNACPR) orders were not adequately recorded.

The CQC also found that systems were not in place to ensure that pre-employment checks were being carried out, and the practice did not hold evidence of mandatory vaccinations for staff.

The access problems patients had been raising for months were also reflected in the report, with inspectors finding that there was poor telephone access, and limited privacy at the reception desk.

And when residents tried to raise concerns, these were also not handled properly by the surgery.

“The complaints policy and procedure were not followed, verbal complaints were not recorded, complaints were not responded to in a timely way and not all aspects of complaints were investigated,” the CQC said.

The practice manager, Dr Saeed has previously disputed the findings in relation to missed diagnosis of kidney disease – which she attributed to ‘coding’ errors – and also that the serious incident involving the child was not handled correctly.

“We are really heartbroken and devastated at the decision to disperse practice list,” Dr Saeed said. “We knew there were issues, some historic but we were under the impression CQC had given us six months and we were ready to work hard to change things for the better.

“We had presented our turn around plan with induction of two new very experienced partners. We had two pharmacist and four new reception staff recruited. We have a GP and a practice nurse lined up for an interview.

“Everything was on the mend and heading in the right direction.

“We are really disappointed and feel sorry for our patients and staff. We want our patients to be reassured that we tried our best to look after them under very challenging circumstances and did everything in our power to ensure safe care was delivered with Covid pandemic, sickness, staff shortages, suspension of long term condition reviews by Health authorities and temporary national shortages of blood bottles.

“We send our sincere apologies to our patients for the inconvenience caused to them as a result of any of our perceived actions.”

Dr Saeed also said the practice was in the process of setting up an online consultation system that would have ‘given us approximately 250 more appointments a week’, with the website set to launch the day the CCG pulled the plug.

Local MP, Angela Rayner, said that the ‘very least’ that residents deserve is an ‘accessible and reliable service’.

“It had become increasingly clear that new leadership was needed at Failsworth Group Practice as there were no signs of the essential improvements needed forthcoming,” she said.

“Over the past year, I have been contacted by many residents who were unhappy with the way they were dealt with by the surgery and I had a meeting with several of the complainants to discuss appropriate next steps.

“Patient safety must always be the top priority so I welcome the decision of the Oldham Clinical Commissioning Group to terminate Failsworth Group Practice’s contract to provide GP services.”

Councillor Brian Hobin, a member of the Failsworth Independent Party has also been involved in supporting residents and trying to help the surgery improve for the last year.

“It’s been long-standing issues and it’s the access that’s the main thing, it’s getting in to see somebody’s what’s mainly been brought up to us,” he said.

“It’s a catalogue of things. They’ve been on the back foot for quite a while. I don’t think it can get any worse than it was.”

However he raised some concerns that the termination of the contract would not be a ‘magic wand’ in improving services for residents.

Currently temporary caretaking arrangements have now been put in place to allow patients to continue to access GP services at the surgery.

While these temporary arrangements are in place the CCG will begin to consult with the patients registered at Failsworth Group Practice as part of a process to establish a ‘permanent solution’ for them.

The most likely solution is that patients will be moved to another practice, with the patient list of 12,166 people potentially being split between Quayside Medical Practice and Medlock Medical Practice, both of which are also based in same building as Failsworth Group Practice.

Mike Barker, accountable officer at the CCG, said the decision to terminate the contract was taken over concerns around the quality of care being delivered at Failsworth Group Practice.

“Patient safety is paramount and we want minimal disruption for patients,” he said.

“For this reason the CCG has put arrangements in place to ensure that patients registered to Failsworth Group Practice can continue to access GP services.

“This means that despite urgent contractual changes, there is no change for patients.

“They will be able to access GP services and arrange repeat prescriptions using the same contact details and if they have an appointment booked, they will still be seen, just by a different provider.

“While these temporary arrangements are in place, we will start to consult with the patients registered at Failsworth Group Practice as part of a process to establish a permanent solution for them.”

If any patients are concerned, they can contact the CCG’s customer care team at oldccg.customercare@nhs.net or 07966 746117.

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