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Practice closures 'not always a problem', NHS England says

Exclusive Practices ‘close all the time’ and it ‘should not be assumed’ it is a problem, NHS England has said in response to Pulse’s investigation that found almost 100 practices have contacted their LMCs in England about potentially closing,

Pulse revealed this week that at least 109 practices in the UKincluding 91 in England – have already approached their LMCs about potentially closing as a result of funding and recruitment pressures.

But NHS England said that closures happen ‘all the time’ and they should be seen ‘in the context of local provision’.

GP leaders said that this showed a ‘worrying level of complacency’ from NHS England.

An NHS England spokesperson said: ‘Practices close (and open) all the time and it should not be assumed that this is a problem or a reduction of service; it needs to be seen in the context of local provision.’

‘Examples of closures might include: closure of surgery or premises in order to move to a different, newer or shared facility; practice mergers to provide a broader range of services for a greater cohort of patients; death of a single handed practitioner.’

But Dr Richard Vautrey, deputy chair of GPC, said that this response failed to appreciate the problems faced by general practice.

He said: ‘The Pulse survey is further very worrying evidence of the growing crisis facing general practice and which is increasingly impacting on patients. It is not only a disaster for the practices concerned but there is a serious domino effect for surrounding practices who suddenly have to pick up large numbers of extra patients.’

‘The response from NHS England shows a worrying level of complacency. There is no doubt that general practice is in the midst of a serious crisis and this is having a real impact on patient services. This is a crisis that requires the Government and NHS England to no longer make excuses but to take urgent action to address and they must start listening to our “Your GP cares” campaign and responding to it.’

Local leaders have warned that the crisis is the ‘worst seen in 20 years’, and that it could get worse following poor GP training intake figures in August.  

Dr Mark Sanford-Wood, chair of Devon LMC, said: ‘I’ve been involved with the LMC for 20 years and I’ve never seen this before. For this to start happening now is significant.’

In Wales, where 14 practices have either handed in their contracts or have considered closing, the Welsh Government is looking at ways of solving the recruitment crisis.

A Welsh Government spokesperson said: ‘We recognise there are concerns about GP recruitment and retention in parts of Wales. Where there are recruitment issues which need to be addressed, the Welsh Government is working in collaboration with the Royal College of GPs, the Wales Deanery, GPC Wales and health boards to promote Wales as an attractive place to live and work.’

‘These include developing new training and recruitment schemes for GPs, considering different contractor models, and looking at how the skills of the whole primary care team can be better used including practices working together locally to help meet the needs of their populations.’

In Scotland, where three practices are at risk because of issues over dispensing, the devolved administration has attempted to tackle this head on.

A Scottish Government spokesperson said: ‘The Scottish Government carried out a full review around access to prescribing and dispensing medicines for communities in rural and remote areas and the impact a new pharmacy might have on their local GP services. The responses to that consultation have been independently analysed and showed broad support for our proposals - the amended regulations build on those proposals.’

‘The new arrangements which came in to last month, are intended to promote stability of GP and pharmaceutical services in rural areas, whilst also ensuring local communities across Scotland have adequate access to a qualified pharmacist.’

Readers' comments (31)

  • All part of the cunning plan to put GP services out to tender to the big corporates and end the corner shop GP provision (which patients prefer)..........

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  • And for one glorious second I thought NHS England had accepted you did not have to be chained to your desk between 8am and 6-30pm five days a week and could close for training and when no demand.
    Alas no.
    It iss just confirminging they are happy for a domino effect of closures to spread and weaken practices to close, untill we are a salaried employees of a HMO.......

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  • So, can LMCs confirm the number of approaches they have had from interested parties looking to open new practices? And how many of the 109 practices mentioned are in fact merging or otherwise continuing with another structure?

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  • Vinci Ho

    No surprise from NHSE- arrogant with a chip on the shoulder. If this is not an attitude problem , my English is too poor to describe, Ha Ha Ha!
    On the contrary , the Welsh and Scottish counterparts are far more humble and realistic. Why is that?

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  • Perhaps NHSE could furnish us with details of how many practices have closed and opened each year for the last few years and why? I suspect that both the reasons for and the number of closures now will look quite different than 5 years ago!

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  • How does NHSE explain ‘in the context of local provision’ when it comes to isolated rural communities. Does this mean that patients will have to travel unacceptable distances to access care in the future. One of the great successes of the NHS was an equal geographical distribution of doctors across the country. Rural practice payments were swallowed up in MPIG and now these small practices will gradually be strangled out of existence. Access to care is a basic human right within the declaration of human rights (Article)

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  • Ostritches

    head

    sand......?

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  • Their only disappointment is that practises are not closing more quickly .

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  • Not a problem for whom - OK NHS England don't care - well they should - they are the commissioners of Primary Care - they should care. Dispersing the lists of small/single handed practices when they close may be part of NHS England's plan to force us all to move towards supermarket style primary core ("its how you tell em" core that is rather than couldn't care) - small practices closing put an intolerable pressure on the remaining practices in an area and a domino affect ensues. Companies like Virgin or local community Trusts running mega practices is the end of traditional general practice - and it happened on our watch - for me I've had enough and I've handed my resignation in to the practice and will be leaving on April Fool's day after 34 years in NHS - 34 yrs ago I'd hoped to make it 40 years as a GP - as was the way in 1970's and 80's - remember the fuss when they brought in compulsory retirement of GPs as principals at 70!
    NHS England doesn't care - well good for them - sad so many of us in our late 50's have decided to jack it all in - who ever is last - could they turn the lights out please when they leave

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  • Does NHS England understand the meaning of the word "closure"?
    "‘Examples of closures might include: closure of surgery or premises in order to move to a different, newer or shared facility; practice mergers to provide a broader range of services for a greater cohort of patients; death of a single handed practitioner.’"
    NONE of these are closures - although the death of a single handed practitioner might be used by the commissioner holding the contract (NHS England) to force the closure of the practice.

    Could Pulse check whether they have understood the meaning of the word as applied to GP practices?

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  • "should be seen ‘in the context of local provision"

    Local provision is almost universally at crisis point in every locality. I think in the past 3 years I have met one GP who has actually been looking for more patients.

    Does that mean that NHSE agree that every closure is an absolute catastrophe?

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  • NHS England are incompetent a*******s promoted beyond their ability who could not care less about medical primary care but they are only carrying out the evil Hunt's mission

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  • In response to both NHSE + Liz closure means closure - if LMCs were talking about mergers or other option these woluld be called exactly that, not closure. We are dealing with people handing in their contracts and potential domino collapse of neighbouring practices and all NHSE can do is play games with semantics.

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  • 'No pit closures'. Remember that slogan from the miners' strike

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  • Either we are overpaid in market terms and therefore this is the market. I have just returned from the USA where medical care is a nightmare with the threat of bankruptcy if you fall ill.
    Here take home pay of £3 per consult is unlikely to be matched by any private provider and Private companies taking over the NHS is going to hugely expensive for the patient. We will, I predict, get EWTD protection and all other employee rights.
    But, anyway, we as a profession cannot be dictated to NHSE in this arrogant manner. Come on GPC, is it not time to ballot for mass resignation.? How come GPC seems so unconcerned, so inept when 100+ practices are closing on its watch?

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  • I've had a Commissioner repeat three times; 'I don't have to listen to people'. 'I don't care what people say' - and this was a reponse to a Consultation which had been done asking patients whether their Practice should be closed. The overwhelming reponse was - the Practice should not close.
    The irony was that the Commissioners had spent thousands on doing a survey and when the reponse came contrary to their expectations - I don't care what people say.
    This is NHSE - find out the backgrounds of people employed in NHSE, their private and political associations with Providers, parties and the Trusts, and you will find a pattern of abominable roots sucking away the life from our NHS.

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  • It will matter when all GP`s send a letter to NHSE stating they are considering closing their practice 1 month BEFORE the election.

    We want mass balloting now.

    The will be on their knees.

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  • GPs and your union haven't got the moral courage to stand up for yourselves, you will cave in.

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  • Actually NHS England wanted practices to close so that they can hand over contracts to their pauls (Private companies) In our area all the new contracts have gone to private companies none to GP/ or Group of GP's

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  • Can NHS England define "all the time". How many practices have closed in the last 12 months?

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