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GPs go forth

'Close to collapse' GP practices cut clinical services and routine appointments

Exclusive Workload pressures have pushed over half (55%) of GP practices to cut back on clinical services or consider doing so, a Pulse survey has revealed.

A Pulse survey of 528 GP partners revealed this was one of a range of measures practices are taking in a bid to stave off pressures. This also included reducing routine appointments on offer, which over a third (36%) of respondents said they had done or were considering.

Respondents said this comes as practices are finding themselves 'close to collapse' amid rising general practice workload. 

A Pulse investigation last year revealed record numbers of practices were closing or merging.

Meanwhile, average GP waiting times remained at two weeks despite the Government's GP Forward View rescue package.

The survey showed that:

  • Nearly a quarter (23%) of respondents said they have already discontinued clinical services, with another 32% thinking about it.
  • A fifth of practices (21%) had slashed routine appointments in the last 12 months, with a further 15% considering it.

GPs mentioned 'ear syringing' and other 'minor' services as examples of what had been cut back, alongside travel-related services.

Other measures included attempting to work collaboratively with other practices, including:

  • Just under 10% of partners, who said their practice has merged with another practice and 32% who said they had considered it over the last year.
  • Nearly a fifth of practices (19%) have federated with another practice, whilst a further 37% mulled over it during the last 12 months.

Dr Peter Goodall, a Southampton GP partner, whose practice has thought about merging, told Pulse: ‘We are really close to collapsing, feel that the CCG has not got much to offer.’

One Devon GP, who wanted to stay anonymous told Pulse that practices in the area were under pressure.

A GP in Scotland said her practice is 'refusing private work, such as legal letters and benefits appeals with poor chance of success'.

It comes as Pulse reported that more than a third of practices are considering closing their list to new patients

Survey questions in full

Have you looked at cutting routine appointments over the past 12 months?

Yes, we have already done it – 21%

Yes, we are considering it – 15%

No – 62%

Don’t know – 2%

Have you looked at discontinuing clinical services over the past 12 months?

Yes, we have already done it – 23%

Yes, we are considering it – 32%

No – 44%

Don’t know – 1%

Have you looked at a merger with another practice over the past 12 months?

Yes, we have already done it - 9%

Yes, we are considering it – 32%

No – 57%

Don’t know – 2%

Have you looked at federating with another practice over the past 12 months?

Yes, we have already done it - 19%

Yes, we are considering it – 37%

No – 41%

Don’t know – 3%

The survey was launched on 10 October 2017, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 500 GPs answered this question.


Readers' comments (14)

  • Hardly surprising. Yet the government wants general practice to take over even more secondary care under STP. It’s plainly not going to happen without a huge transfer of funds to primary care from the secondary care budget. Primary care already manages far more critical conditions in the UK compared to primary care in any other country.

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  • This is no accident. The Government hate GPs independent status and have done an excellent job of making the role so incredibly miserable that no one wants to become a GP Partner anymore. When my practice closes down I will feel sadness and relief--but not in equal measure. I am broken and welcome the end.

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  • Cut services during the week but at least the lucky few patients will be able to access some premium priced saturday morning headline vote winning appointments for the politicians to crow about!

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  • Just when will this sad story end? The bottom line is that fewer full time GPs are coming in to replace the ones leaving whatever their reasons. How many times do I have to say that if the government publically says ‘look, with the funds and workforce available we can afford to afford this but not that in Primary and Secondary care’ instead of saying that the public can have what they want, when and where they want it. Such admission is a vote loser so is unlikely to ever be said.
    My demoralisation is both profound and complete. Who will be left to look after me when I need it? After all it’s not legal to treat ourselves is it?

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  • Vinci Ho

    Survival is ‘victory’ . Federate in order to survive, no hard feelings. Question , how long can these bigger and bigger practices even sustain if the government and its health secretary carry on with the same attitude to run businesses?

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  • Hunt is a "nutter".....he seems to live in a parallel universe and has the self-belief of Kim Jong the capacity to believe his own fantasy propaganda.

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  • Knowledge is Porridge

    Blame NHS England for not managing, leading, planning well enough?
    Blame Hunt for not fixing or reforming the NHS within the budget he has?
    Blame the Chancellor for not raising taxes, or spending more debt to fund the NHS?
    Blame the BMA or RCGP for failing to stand up for our interests?
    Blame the voters for tory votes?
    Blame Labour for picking an unelectable leader?
    Blame fat people for being fat, or fast food restaurants for feeding them?
    Blame lawyers for no win no fee?
    I blame the blame culture...

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  • Good idea to drop private work such as legal letters and benefit letters etc. More guidance from the BMA on how to do this would be helpful

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  • @Knowledge is Porridge: Blame ourselves for electing the morons that we elect year in and year out to the LMC and CCGs who have nothing in mind apart from being on the inside to make a fast buck !

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