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News  Newyddion   Last Update: 27th February, 2015

Llanwrtyd Wells Branch Surgery Update - (27/2/15)

Llanwrtyd Wells Medical Centre
Branch Surgery in Llanwrtyd Wells

Yesterday, Builth And Llanwrtyd Medical Practice met with representatives from Powys Local Health Board (LHB) including Alun Lawrie, director of primary care. The meeting was constructive.

No new money was on the table to replace the removal of MPIG. This was extremely disappointing.

The Practice was offered a community care based scheme already operational in other Powys Practices. This scheme would generate income but also increase workload. The Practice is already working at capacity, but by working harder, there would be money to support our branch surgery.
This is obviously not a sound footing for sustainable service provision. However this new income could allow the maintenance of our vital branch surgery, at least in the short term, until a more concrete funding solution is found.
The practice is therefore reviewing the details of the community care based scheme and looking at how the increased workload could be managed.

Of interest were discussions on what more could be done from the Llanwrtyd branch surgery, especially involving our excellent team of community and specialist nurses. We are working with Powys LHB to develop these ideas further.


We will meet with Powys LHB again next week for more positive discussions.

Letter from Builth Wells Town Council (.pdf)

Llanwrtyd Doctors Newsletter Update (.pdf)

Llanwrtyd Wells Branch Surgery Update - (20/2/15)

Discussions with Powys Local Health Board (LHB) on the future of our branch surgery in Llanwrtyd Wells concluded last month.

Powys LHB recognises we are a forward looking practice that has a tradition of embracing positive change. We have sought new ways of working and are leaders in the new Glan Irfon unit, a flagship development integrating health and social care. Currently we are partners in the Carewell Project, which looks at the delivery of integrated healthcare to frail, elderly patients, involving and learning from a number of European regions.

Powys LHB were clear that they were unable to provide a solution to our MPIG funding crisis and could not see any new ways of working that would maintain services in Llanwrtyd.
Yesterday, surprisingly, we learnt that Powys LHB are now keen to meet and discuss the matter further. We will engage and update.

Llanwrtyd Doctors Newsletter Update (.pdf)

BBC News Mid Wales

Lake District rural GP practice is losing MPIG funding and faces closure (BBC Radio4)

Llanwrtyd Branch Surgery Facing Closure - (18/2/15)

Llanwrtyd Wells Medical Centre
Branch Surgery in Llanwrtyd Wells

Dr Richard Walters and Dr Robert Hegedus met with Llanwrtyd Town Council tonight to discuss the uncertain future of our branch surgery in the town.

The branch surgery is likely to close this August.

This a direct result of a Welsh Assembly Government decision to withdraw the Minimum Practice Income Guarantee (see below).


We have written a letter to Health Minister Mark Drakeford expressing our concerns and inviting him to visit Llanwrtyd Wells to view the Health Centre and perhaps meet with patients and staff. The full letter is detailed below.


We will keep you informed of any developments.

Dear Minister,

We would like to extend an invitation to you to visit our important NHS branch surgery at Llanwrtyd Wells, which you will be disappointed to hear will close this August as a direct result of the removal of the Minimum Practice Income Guarantee (MPIG) from practice funding. We can accommodate any date and time for your visit.

Background - Llanwrtyd Branch Surgery Services

We and our community are very proud of our branch surgery; it serves 1,200 patients and is located 13 miles west of our main surgery in Builth Wells. The purpose built premises opened 21 years ago and the current lease expires in August 2015. There are two consulting rooms, a nurses' room, treatment room, staff room and a room allocated to the Health Board which is utilised by a variety of staff to see patients on their case load. There is a doctor's surgery every morning and additional services include phlebotomy, anticoagulation, falls clinic, leg clinic, health visiting and counselling. There are well over a hundred consultations with users each week. An excellent dispensing pharmacy (not practice owned) is situated in the same building which also serves as a Citizens Advice Bureau branch.

Llanwrtyd Wells is a large rural town with a high proportion of elderly patients with complex medical problems. The patients there use the services appropriately and have inputted positively to new developments in facilities and services over the years. The branch surgery facilitates the goal of bringing patient care closer to home.

There is inadequate and infrequent public transport from Llanwrtyd Wells to Builth Wells and without a branch surgery patients could face numerous lengthy trips for even routine appointments such as, 'flu jabs, blood monitoring, warfarin monitoring, respiratory and cardiology reviews. Travel would simply not be possible for some patients, especially in winter.

MPIG and Builth & Llanwrtyd Medical Practice

MPIG removal is a massive financial loss to the Practice equating to losing 56,000 phased in over 7 years. According to our accountants the Practice is highly efficient financially meaning there are very few practical ways to make any savings, beyond those we have already implemented such as economising on staff costs and removal of some services. Even these will not replace the significant loss of MPIG.

Like most rural Practices, GP income at Builth & Llanwrtyd Medical Practice is below the national average. Reducing our pay further to offset MPIG loss is an option but, and as you are well aware, there is already a GP recruitment crisis nationally, which is particularly felt in rural Powys and reducing income means Practices become less attractive to new GP partners and ultimately less attractive to existing GP partners.

The Practice therefore cannot afford to run the Branch Surgery Service and continuing to do so would make the Builth Surgery unviable - forcing closure of all GP services in the Builth & Llanwrtyd locality. This is clearly a potentially disastrous situation.


We are sure that when MPIG removal was agreed, consequences of this nature were unforeseen but we feel compelled to highlight the impact on community health services in our locality that such a move will cause. We would welcome the opportunity of showing you around our branch surgery, and perhaps meeting staff and service users (a mutually acceptable agenda could be agreed later). We hope you will consider a review of rural practice funding with a view to supporting rural practices and their branch services.

Yours sincerely

Builth & Llanwrtyd Medical Practice

Carol Shillabeer acting Chief Executive Powys Teaching Local Health Board
Professor Vivienne Harpwood, Chair Powys LHB
Kirtsy Williams AM
Roger Williams MP
David Adams CHC
Llanwrtyd Town Council
Builth Town Council
Builth Surgery Website

Minimum Practice Income Guarantee (MPIG) - (7/1/15)


Builth & Llanwrtyd Medical Practice is currently dealing with a massive reduction in funding which will result in loss of services.

We are a NHS rural practice, with a branch surgery in Llanwrtyd, serving a total population of around 8,000 patients.

In 2004 when the "New GP contract" was brought in and the funding of practices was changed, there was an introduction of the Minimum Practice Income Guarantee (MPIG) which was designed to prevent financial de-stabilisation of practices.

The contract stated that this MPIG would remain in perpetuity so long as it was needed. If it was needed then it is needed now.

In 2014 the Welsh Assembly Government decided that MPIG will be withdrawn over a period of 7 years (without GP agreement). Reduction of funding starts this year.
The loss of the MPIG is causing concern as some practices will face the threat of becoming non-viable and others including Builth & Llanwrtyd Medical Practice will be unable to fund the current level of service provision.
Powys Local Health Board are fully aware of our funding reduction. We will keep you informed of developments.

Thank You - (27/12/14)

Thank you
Thank you

A big thank you from Builth & Llanwrtyd Medical Practice to our patients for the generous gifts given this festive season.


Your thoughts and kindness are much appreciated.

Season's Greetings and a Happy and Healthy New Year to all.










Surgery Closing Times for the Festive Season (22/12/14)


Both Surgeries Closed:

Thursday 25/12/14 and Friday 26/12/14.

Thursday 1/1/15.

"Shropdoc" will provide cover at these times.








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