Guide to practice mergers: Engaging with patients during a merger

When two practices merge through the acquisition of one practice by another, typically this means that practice A will take over the patient list of practice B. In all of the mergers via acquisition that I have been involved with the local NHS area team has required Practice B to canvass the views of their patients about the change. Rightly so. Patients are often very interested in what is happening at their local practice and it is important to take account of what they think.

You may need to produce a report for your local council’s overview and scrutiny committee providing information about your proposal and include the views of your patients and stakeholders.

Even if your merger is not an acquisition, you should engage with patients and ensure that they understand the benefits of the changes that you are proposing.

Here are ten tips for engaging with patients and stakeholders during a merger.

1. Get advice from your area team

When you first meet with your local NHS area team to discuss your merger, agree with them in advance how you are going to engage with your patients. Your area team may have experience of presenting reports to the overview and scrutiny committee so ask if there is anything that the committee particularly like to see included. Sometimes the area team may contribute to the cost of engaging with patients, so ask about that as well.

2. Be honest

Be honest with your patients about the reasons for the merger. Produce a clear information sheet that explains who you are proposing to merge with and when, the main reasons why you want to merge, and what the main changes and benefits for patients will be.

If there are any adverse effects for patients then be upfront about these too (they will come out later anyway), for example if a site is going to close and some patients will have further to travel, or if on-site car parking will no longer be available. Importantly, explain how you have tried to mitigate these effects and, if this has not been possible in all cases, why you still feel that the benefits of your proposal outweigh these issues.

3. Get feedback

Design an easy to complete feedback form for patients to fill in, and give them plenty of space to include their own comments. Provide different ways for patients to provide feedback too, taking into account patients’ different access requirements.

Consider setting up a dedicated email address, having prominent boxes in the practice waiting rooms for feedback forms to be returned to, enabling receptionists to complete forms on behalf of patients who wish to pass their views on verbally, using social media where you can, and planning at least one open meeting where patients can meet GPs and staff from both practices and ask any questions they might have.

If you are relocating to a different site then consider having the open meeting there so that patients can have a good look around. Don’t forget to let your patients know the outcome of their feedback and keep them informed of progress.

Consider posting the information sheet and feedback form direct to all your patient households so that no-one is missed. Some patients may not visit the practice often enough to see posters in your waiting room and they may not use your website.

Although the NHS Area Team has never asked practices I have worked with to formally gather feedback from practice A’s patients when practices are involved in a merger by acquisition scenario, I think it is important to include them in any consultation exercise.

4. Use your patient groups

The patient participation groups at both surgeries can be a great asset in answering patient questions about your proposals and feeding back any concerns patients may have. They can also have a very reassuring effect when they are present at open events too, so do involve them when planning these.

5. Use this as a PR opportunity

Maximise the PR benefits of engaging with your patients because it won’t just be your own patients that see the information about your proposals. Promote the calibre of the GPs, staff and resources that will be coming together and the increased expertise, continuity and services that this may provide. Use your local press where you can but be aware of the usual caveats that go with working with the press.

6. Obtain the views of other stakeholders

Identify and contact your local stakeholders to let them know what is happening and ask them for their views as well. Depending on the level of response that you get, you may need to have an open event just for them.

7. Overview and scrutiny reports

After the survey, work with your local NHS area team to produce a report for the overview and scrutiny committee and be prepared for GPs from both practices to have to attend in person. Make sure the report is accurate and there are clear audit trails to verify any results or findings that you include.

8. Accept you may lose some patients

Some patients may decide to move to another practice as a result of your proposals, especially if you are relocating and they face genuine difficulties in getting to the new practice. Try not to take this personally, they may be as sad to leave as you are to see them go and – of course – they may well return after a short period of registration with another practice.

Let patients know what they should do if they want to move practices, though emphasising that you hope they will stay with you. Provide details of organisations patients can contact if they need help deciding what to do and then let these organisations know in advance about your proposals so they are well informed and can support any patients that contact them.

9. Information for patients after the merger

Help patients settle into the new practice quickly by providing a timely Q&A sheet that tells them all they need to know about the new practice. Be particularly clear about any interim arrangements that are being put in place (especially for booking appointments and repeat prescriptions). Even if something isn’t changing, let patients know to avoid any confusion e.g. if opening times are remaining the same.

10. Involve patients in celebrating the new practice

It’s not every day that a new practice is born so take a moment to celebrate with your patients the start of a new era.

• Dee Lynes is from consultancy brightSOLUTIONS, which specialises in working with GP practices and third sector organisations. Visit www.brightsolutions.info or email enquiries@brightsolutions.info.
• Dee is running a seminar on 21 July in York entitled GP Practice Mergers - What's really involved?. Click here for more details.