Pond Tail Surgery, in Godstone, Surrey, is a well-established practice with a registered list size of approximately 7,000. Uncertainty about Pond Tail practice has arisen since the sad, untimely death of the former, single handed contract holder, Dr Khan-Gilbert.
What do I need to know as a patient?
There are currently no plans for the practice to close. Surrey Heartlands Clinical Commissioning Group (CCG) intends to run a competitive procurement process to find an appropriately qualified organisation or individual to provide primary care services from the current Pond Tail Surgery premises.
Delivery of services is reliant on the availability of the existing premises. Surrey Heartlands CCCG is currently participating in positive negotiations with the landlords of Pond Tail Surgery to agree continued occupancy of the existing building for at least the next five years. These discussions must conclude satisfactorily for both parties before a competitive procurement exercise will be launched.
You do not have to do anything. There is no change to patient care and, we anticipate, there will not be once a new contract commences. Services continue to be available and accessed in the usual way. All patients will be informed once the dialogue with the landlords and subsequent procurement process is known.
The surgery has a registered list size of approximately 7,000.
At the present time there is no need to register elsewhere. Pond Tail Surgery remains open and continues to provide care to the registered patient list. Following our December 2020-January 2021 patient survey, the CCG has clearly heard the preference expressed by patients to retain services in Godstone and is working hard to deliver this. In the very unlikely event any alternative arrangements need to be established, patients will be supported.
The patient list size will be a consideration for potential bidders as there needs to be a list size large enough to present a viable business opportunity. Should the list size reduce because of patients migrating to other practices, the opportunity may appear less attractive to potential bidders. Ultimately, however, the decision to stay or leave Pond Tail Surgery lies with each individual patient.
A panel made up of CCG matter experts e.g. Finance, Clinical, HR etc. although we are currently recruiting for a patient representative to assist with the evaluation.
Yes, but the surgery has already been through many contract changes in the last 10 years. We fully appreciate that the potential bidders will all have their own models of care and staffing arrangement proposals. It may be a combination of a new contract holder with the existing staff being retained.
We fully appreciate that the practice has been through a very difficult period and some staff have chosen to leave, however the CCG has a team working very closely with the staff in order try and improve processes and to make it better for patients.
The current Landlords are the former GPs.
The pandemic has changed many of the ways of working for general practice. They have always undertaken telephone consultations, but video consultation was not routinely used before. GP practices have had to change their systems overnight in response to the pandemic. We are now coming out of some of the pandemic restrictions and are adapting to keep what has worked well whilst identifying what does not in order to deliver the optimum offer. It is about the balance between different ways of working; looking to maximise face to face and telephone access for those who require it and also permitting remote access for those who need and/or prefer it. We are currently undertaking significant work on processes and system improvement and development with the Pond Tail surgery team to support them to deliver a quality service more immediately, regardless of the eventual procurement outcome.
Yes, strategically we are aware of these plans and hopefully, by securing a minimum 5 year contract, this will give us the time and opportunity to consider how healthcare services can be provided to the whole area in the future.
There used to be a standard algorithm in place whereby 1 GP would be responsible for a number of patients, however this is no longer the case as staffing models have had to change to incorporate a more diverse workforce e.g. pharmacists, paramedic practitioners. The NHS England strategy is to bring in a mix of skill sets to general practice.
Essentially yes, but they will need to provide details and explanation about their model of care including details of proposed workforce, which will be evaluated by the CCG.
Practices are private businesses, and the GPs are responsible for recruiting and overseeing staff employment. We are in constant contact with the GP and practice manager at Pond Tail Surgery.
Between 10 December 2020 and 18 January 2021, we carried out an informal engagement to advise patients registered at Pond Tail Surgery about the different options under consideration. We also undertook a survey to inform us about your preferences going forward. A summary of responses is available on the Surrey Heartlands Clinical Commissioning Group (CCG) Pond Tail Surgery webpage.
During June 2021 we are holding face to face and online patient information sessions which will provide an opportunity for patients to hear first-hand from Surrey Heartlands CCG about the process for procurement and to ask any questions you may have. Detail of the sessions is below. Patients can register via the Eventbrite links on the Pond Tail Surgery webpage.
Face-to-face information sessions
Six events, each lasting 30 minutes, will take place on Wednesday 9th June and Monday 14th June between 10am and 4pm at The White Hart Barn, 71 High St, Godstone RH9 8DU. There is public car parking opposite The White Hart Barn.
Online patient information sessions
Two online events will take place via Microsoft Teams on Thursday 10th June and Tuesday 22nd June from 7pm to 7.30pm.
The CCG and GP practice is using all available channels to communicate with patients – letters, text messages, public meetings, local word of mouth and displays, online materials, websites, and social media.
Patients on the practice registered list do not need to worry; the very fact they are registered ensures they remain eligible for care as needed. If the procurement process does not result in a new contract holder (please refer to ‘About procurement’ section) and the decision is subsequently made to ask people to register elsewhere, direct communication will be made with registered patients and clear messaging will inform callers to the practice telephone line and/or website. All patients will be given clear signposting to further support. We emphasise again that this is not our preferred option, and all efforts are being made to avoid it.
We will work closely with all vulnerable patients to provide individual support and ensure their care needs are met as best as possible. We will also be asking a specific question of bidders during the procurement process about their delivery of care to vulnerable cohorts of people. This is a question for which we are seeking a patient evaluator as we know it is significant.
If you are concerned or have concerns about somebody else, please contact us.
We acknowledge that it has been very difficult to communicate with patients during this COVID-19 pandemic, especially for those patients who do not have access to IT. However, we have actively engaged with local Councillors, Parish, Borough & District Councillors, Healthwatch, health colleagues, community and voluntary groups to ensure that patients received appropriate information relating to Pond Tail Surgery.
We are posting all information in the surgery too although we appreciate access is limited at the present time. Please do let us know of any questions that you may have by contacting the surgery if you are unable to get in touch with us directly via our online capabilities. We are in constant communication with the practice and will be advised of queries and comments.
Our current arrangements permit the CCG to directly contact all patients only once in these circumstances, more in the event of practice closure. We have not yet written directly to patients but instead used a variety of alternative engagement and communication methods and means. At the point at which we have confirmation of the future of the practice we will write to patients to advise them.
We will be expecting the new contract holder to host a Patient Participation Group (PPG). On award of the contract the new provider will communicate to the patient list how this will be established including the process for joining. We will continue to communicate with you all via every available avenue.
Procurement is the act of obtaining goods or services, typically for business purposes. Procurement is most commonly associated with businesses and larger organisations because they need to engage services or purchase goods, usually on a relatively large scale.
Procurement is also the term used to describe the process of purchasing goods or services via a tendering or competitive bidding process. The buyer, in this case, Surrey Heartlands CCG, describes the characteristics and/or the specifics of the product or services they wish to buy and requests responses to a series of questions from capable organisations termed as, “bidders.” It concludes by appointing a specific provider, a specified number of providers or a collaboration of providers as allowed under the terms of the process that is published to bidders.
Surrey Heartlands CCG is obliged by law to advertise the opportunity to provide GP primary care services at this practice. After the devastating death of Dr Khan-Gilbert we were permitted by NHS England/Improvement to set up a temporary contract with Dr Shazia Chaudhary to ensure continuity of care for patients. This was with the understanding that prior to expiry of Dr Chaudhary’s temporary contract on 31st December 2021 new permanent arrangements would be established to take effect from 1st January 2022.
Having identified that there are no proceedable alternative sites available within the local area and required timeframe, in the event that the CCG fails to successfully conclude negotiations with the landlords and the existing premises become unavailable it would become necessary to close the practice and ask patients to re-register at alternative local surgeries. This is not the CCG’s preferred option.
The opportunity to bid for this service will only be released by Surrey Heartlands CCG if negotiations with the landlords are successful in securing access to the premises for a minimum term of five years.
The procurement process itself does not guarantee bidders coming forward nor the appointment thereafter of a new contract holder, however, Surrey Heartlands is maximising the likelihood of this by releasing as much information to the market as possible. This will allow potential bidders to decide if the opportunity is right for them. Information will include, but is not limited to, a profile of practice activity, a Service Specification, Contract Terms and Conditions, Lease Heads of Terms, Asset Lists, Staffing Information etc.
The only reasons why a competitive procurement may not result in the successful, award of a new contract are:
• No bidders respond to the opportunity.
• Bidders do not meet the qualifying criteria to progress to the scored assessment stage in the process.
• Bidders fail to reach the pass mark during the assessment stage.
• Bidders fail to produce information, by a deadline date agreed, on which their bid is founded.
• The winning bidder fails to sign the contract at the end of the process.
No, no alternative premises were identified that would have been possible to acquire and make fit for use within the time available prior to the end of the current temporary contract.
It runs co-terminus with the current contract which concludes in December 2021.
It remains static at approximately 7,000 registered patients. The status is now quite stable; it is routinely measured on a quarterly basis. There had previously been some movement, but this has slowed, and we have not seen material change to the list size. There were in the region of 1,800 respondents to our recent engagement and we clearly heard patients’ expressed desire to stay in Godstone. After some initial concern about list movement we issued communications in that regard which you may have seen.
Locally in East Surrey, Oxted Health Centre is much larger, Caterham Valley about 10,000 and Lingfield also quite large. Pond Tail is relatively small but an average NHS list size for a single handed GP practice is circa 8,000. Below 5,000 would be considered a small practice. We believe this opportunity is an attractive list size for which to bid.
There are a variety of premises arrangements in the SH CCG patch. Previously the some of the practice premises were owned by the NHS however this changed a few years ago with the formation of NHS Property Services (a limited company owned by the Department of Health that took over the ownership of around 3,600 National Health Service (NHS) facilities in April 2013). Many GP’s own their practice premises. On occasion GP landlords who no longer practice are willing to sell the premises to a new contract holder or they continue to own the premises and rent them back to the practice GP(s). The Pond Tail premises are owned by three former GPs and they let the premises to the current contractor. A CCG itself, cannot own property. We are therefore liaising with the landlords to try to establish continuity of occupancy. We are attempting to secure agreement to continued occupancy; the actual terms of the lease to be agreed will be a negotiation between the landlords and an incoming contractor. They will need to finalise the terms of the premises lease.
The bidders will propose to us their operating model and we will assess it against set evaluation criteria published to them on release of the tender documentation. Example: A model could be a single GP or any number of GPs/individuals. There are many types of people who work in a GP practice. It could be one GP who holds the contract but then employs others to work in the practice. There will likely be a whole suite of staff in the surgery. We have not specified the model of care though we have stipulated the specific requirements regards the anticipated deliverables all of which will be communicated to bidders.
That’s right, yes, as otherwise the late timeline will impact the viability of any next steps. The landlords understand this deadline and are working with us to this tight timeframe. We will confirm to the local community, at the earliest point we can and publish the link to the tender opportunity when it is available.
Service models will look different. Currently one GP holds the contract but has many people working for her. We ask that bid proposals include staffing structures and service model recommendations amongst other criteria. These proposals will differ depending on who the contract holder becomes. The skill set within GP practices is evolving each year. Commercially GP practices receive reimbursement for particular new roles in support of care delivery. Further, additional clinical skills and specialist services may be identified as being necessary when analysing the patient list e.g. diabetic or paediatric specific care. This will allow for different skill sets depending on the care and treatment requirements of the practice registered list.
Nowhere has been identified that does not require a considerable amount of work to ready it for a primary care service. However Primary Care Networks are now delivering services in a collective way. Some services could be offered remotely or face to face in this new collective model which is not contingent on size of premises. We recognise there are some limitations with certain locations, not only Pond Tail, due to size but delivery could be offered differently e.g. over weekends or at different times of day.
All tender paperwork is authored, and we are only awaiting final landlord confirmation and the terms of the lease as these need to be issued with the documentation. Our timetable represents the standard time allowance for a procurement and most of that allocation is attributed to bidder responses and mobilisation as it is important to ensure the provider is established and ready to commence services from 1st January 2022. We have a simplified mobilisation as there will be no need to change premises. We have had to balance our timetable against the possible need for a Plan B and the time allowed for that should we be forced to enact a dispersal.
A number of GP practices have limitations with the size of their premises, and many are not big enough to cope with the current workload. We are working with the practice to look at ways of utilising space more efficiently and thinking about different ways of working – for example, the appropriate use of clinical and administrative rooms.
The contract is a standard contract, however the way in which services are delivered are determined by the providers.
An external estates team reviewed over 30+ potential proposals, however unfortunately no suitable sites were identified in the immediate area that could satisfy the timescale requirement, therefore many proposals were discounted at the desktop stage.
With respect to the data there are a series of measures in place within the contract to ensure that patient data is protected – the General Data Protection Regulations impose restrictions upon the transfer of data outside of the European Economic Area
The NHS APMS contract is available online for anyone to check the requirements for data protection.
The current contract is a temporary one with Dr Chaudhary which expires on 31st December 2021. The procurement process will provide an opportunity for providers to bid for the new APMS contract. We would expect to see bidders putting forward their model of delivery and staff arrangement proposals that would best suit the needs of the practice population.
Surrey Heartlands Clinical Commissioning Group (CCG) will run a process called an “Open” Tender with Combined Response. This means that potential bidders will need to complete a standard assurance and due diligence (qualification) questionnaire along with their answers (bid submissions) to specific quality questions directly related to the running of Pond Tail Surgery. The process is undertaken in a single stage (hence the term combined response). This means bidders will make one submission with all their answers to all questions.
The steps to be followed for this procurement are:
1. Publish all the Tender Documents including the service specification.
2. Bidders submit their Tender responses.
3. Evaluators will independently evaluate the responses.
4. The Evaluation Panel will conduct a Moderation process to reach a single agreed score per question.
5. The bidder with the highest score against the published scoring methodology will be agreed as the successful provider.
6. Contract Award.
8. Service Go Live 1st January 2022.
Mobilisation refers to activities that should be carried out after the contractor/s has been appointed, but before they take responsibility for service delivery. It is a preparatory stage during which service delivery is maintained by the existing contractor, but the newly appointed contractor is readying themselves.
It will include things such as:
• Understanding operational activities
• Ensuring all IT & IG transfer arrangements are made appropriately
• Setting up any new services
• Establishing relationships with existing staff and on-boarding potential new clinical and operational staff
No, we are waiting for negotiations to conclude with the landlords securing the length of the lease and the Heads of Terms i.e., the conditions of the commercial lease transaction to be agreed in principle between the new contract holder and the landlords.
Once the tender is released it is a lengthy process to complete. We aim to conclude by Autumn 2021 to allow time for the newly appointed contract holder to mobilise their service ahead of the Go Live date of 1st January 2022. Arrangements are in place to ensure that services are maintained at Pond Tail Surgery until the procurement process is completed.
We are looking for someone to become a key member of the Pond Tail Surgery Procurement Evaluation Team, which has been established to assess bid submissions in the procurement for the provision of a GP Service for the Patient List of Pond Tail Surgery. Please find more details here.
Transfer of Undertakings (Protection of Employment) Regulations 2005 (TUPE) may apply and therefore some staff may be retained. If you mean would a company employ new doctors this is also possible, and they could be employed as what is known as Salaried GPs or be practice partners.
Any organisation qualified to bid for this opportunity can do so. Therefore yes, that is possible. Bidders will be asked to respond to compliance questions to assess their competency and capability to bid, after which, they will be evaluated against a series of technical and quality questions which have been authored to draw out specific information about the service delivery model and approach for Pond Tail Surgery.
This is an open tender opportunity for any qualified organisation/individual which/who may seek to bid. Information about the circumstances of Pond Tail Surgery is public and can be found on the Surrey Heartlands Clinical Commissioning Group (CCG) Pond Tail Surgery webpage.
You will also find a link to the Prior Information Notice (PIN) published for bidders on that page or the GOV.UK website on the Contracts Finder webpage.
Once the opportunity goes live, we will update the CCG webpage and also provide a link to tender documentation.
The contract is being advertised competitively and will be open to any/all providers meeting the qualifying conditions.
Yes. We released a Prior Information Notice (PIN) and have had interest registered for the opportunity from multiple parties whom we anticipate would be able to meet the threshold for provision of primary care services.
We pull together a series of questions about experience, quality delivery, service model propositions including how the eventual contractor will work with patients and the local community, workforce profile and other considerations. The bidder achieving the highest score on conclusion of the published process will be awarded the contract.
No. Tender responses will only be reviewed by a set of Subject Matter Experts who will evaluate the bids. The identity of bidders will not be made public, and this is due to commercial sensitivity. You will likely see some information about the eventual contract holder in marketing materials after appointment. For assurance, please understand we are committed to securing all the services currently on offer - though a bidder may also want to improve on these e.g., there could be additional methods of access, an improved website and enhanced information available to you. We would expect to see improvements to the ways in which some processes are enacted.
There is an opportunity for a patient evaluator to support the CCG. Information about the role of Patient Representative for Pond Tail Surgery Procurement Evaluation is explained here
Inability to identify a new contract holder
If it is not possible to conclude negotiations with the landlords and release a tender; or if the procurement process does not result in a preferred bidder for the reasons stated in the ‘About procurement’ FAQ section, then it would be necessary to close the Pond Tail GP practice. Patients would be required to register with alternative local practices, this process is known as “list dispersal”. We understand that this may be unsettling for patients, and we would provide full support to help them should this course of action become necessary. We hope that it will not. This is not the CCG’s preferred option.
This would involve running face-to-face sessions where we help people to identify another local surgery that meets their individual needs. We would explain the steps involved in registering with another surgery and support the practice staff at these sites to accommodate the influx of newly registering patients. Your medical records would follow you when you re-register with another practice. Information would not get lost, and this would be overseen and managed by the CCG.
If closure is the final outcome, based on previous experience Surrey Heartlands CCG is confident there will be enough time to support all patients.
How to submit feedback
Surrey Heartlands CCG welcomes patient feedback at every stage and all comments will be taken into consideration.
- Tel: 0300 561 1555
- SMS: 07917 087 560 (text phone only)
- Write: FAO Communications and Engagement Team, NHS Surrey Heartlands CCG, Cedar Court, Guildford Road, Leatherhead, Surrey, KT22 9AE and make sure you include your full address and postcode
- Pond Tail Surgery (Godstone) Future GP Services
- Pond Tail Surgery (Godstone) Future GP Services - Background and Updates
- Pond Tail Surgery (Godstone) Future GP Services - Bidder Information
- Pond Tail Surgery (Godstone) Future GP Services - FAQs
- Pond Tail Surgery (Godstone) Future GP Services - Patient Information Sessions
- Pond Tail Surgery (Godstone) Future GP Services - Patient Survey
- Pond Tail Surgery (Godstone) Future GP Services - Patient Representative