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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)

  • This is very worrying to hear.
    Either:
    1) They realise what is going on and do not care.
    Or
    2) They are very stupid and cannot see what a crisis General Practice is in.
    Both are bad!

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  • Dr Hawking, I wouldnt be at all surprised if they were refering to closed lists!

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  • @PM 10:52 - Quite agree, we GPs are a divided lot and fear our own shadows. Our Unions are impotent because they are politicians in their own rights. And to be honest - GPs also vary - some are well off with 'deals' from PCTs and the others struggling. To sume it - we don't have the balls needed to make a change.

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  • GPs, on the whole, avoid conflict and that is a nice civilised characteristic but it does leave you open to abuse, and boy are you being abused now! Protection comes from sticking together but that is sadly where GPs can always be relied upon to betray each other. You always act in individual selfish self-interest and not for the profession as a whole. You do not stand firm, side by side, for the principle of the thing. If any GP sees they are not affected or they are doing OK or it doesn't fir their ideology they will abandon all the others. And thus the DoH can carve you up. The GPC is pretty much useless but I bet they know if they try any action then plenty of egotistical GPs will pop up to denounce it instead of keeping quiet, or not turn up to man the barricades and the GPC will be left looking silly.
    GPs always remind me of Martin Niemoller's famous poem-
    First they came for the Socialists, and I did not speak out--
    Because I was not a Socialist.

    Then they came for the Trade Unionists, and I did not speak out--
    Because I was not a Trade Unionist.

    Then they came for the Jews, and I did not speak out--
    Because I was not a Jew.

    Then they came for me--and there was no one left to speak for me.

    Just change it to things like PMS contracts, pensions, dispensing practices, charging patients, etc and you get the idea.

    I like GPs a lot, I have been working with them for decades and wish to do so for decades yet (though I think general practice and my job will be gone within 5 years) but you really are hopelessly selfish and your prioritisation of your individual egos over your collective needs, is your downfall.

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  • I absolutely agree with Practice Manager 12.58.
    We only have ourselves to blame. 12% support for BMA's Day Of Action. Pathetic!

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  • Vinci Ho

    People shared the same objective before they could be united not the other way round:-
    'Shared' the same objective simply because they were in an unity.
    The questions one to ask oneself ,'Why am I not in an unity when I have the same objective?' OR ' Why do I not believe in the same objective of the unity?'

    What is one's real 'objective(s) or agenda(s)?

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  • what certainly is always a big problem...is the political front/quango called nhse which without accountability does the governments covert dirty work.

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  • Working for a private GP service was one of the worst and traumatic times of my career. My nurse clinical decision differed to their computer on one occasion (my other GP employer agreed with my decision) and I felt I had landed in an old American gangster movie. Only the spot light in my face was missing. I was so traumatized and felt so vulnerable, I left. I wrote to the CE to complain and did not even get a response.

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  • Closure of small rural practices is not uncommon in other countries
    It is a fact of life that most young GP's want to stay and work in "fleshpots"

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  • http://youtu.be/l2IngrAq7yA--please see

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