This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

GPs buried under trusts' workload dump

Revealed: Sixty GP practices across the country facing imminent closure

Exclusive Around 60 practices across the UK are facing imminent closure due to issues over funding and recruiting staff, Pulse has learnt.

In a measure of the recruitment crisis and funding squeeze facing the profession, local GP leaders have warned that they are witnessing an increase in the number of practices considering giving up their contracts altogether.

Pulse surveyed 25 local GP leaders from across the UK, and found that 60 practices were either notifying their patients about their closure or were in talks about relinquishing their contract.

The leaders of local medical committees (LMCs) or GPC representatives told Pulse that they fighting to keep practices open, but were facing a ‘slow train crash’.

They also cited the ‘domino effect’ that would occur if practices were allowed to close and large numbers of patients had to be reallocated to other neighbouring practices.

The BMA warned in May that practices were ‘imploding’ with the pressure on them, and that was leading to many being at risk of closure.

The survey found:

  • In Gloucestershire, three practices are under imminent threat of closure with GPs at one taking home no pay at all.
  • Six practices in Hampshire have been in discussions with LMC representatives about relinquishing their contracts.
  • One practice in Oxfordshire has closed this week because it could not afford the running costs, another is due to close due to a lack of investment in premises.
  • In Wales, four practices are closing imminently, and a further 10 are considering doing so due to recruitment problems.

Gloucestershire  LMC chair Dr Philip Fielding said: ‘We’re working with the area team and CCG to find a way of keeping them viable, and also to keep planning succession.

‘In one practice, the partners are taking no drawings. They are retired in terms of the NHS pensions, but they’re staying on for nothing to look for a successor. In another practice, the salaried doctors are earning more than the partner. It’s inherently unstable - it’s like trying to stop a slow train crash.’

Dr Charlotte Jones, chair of Wales GPC, said: ‘We have a number of surgeries in Wales that are in the process of terminating their contracts. There are examples in both urban areas and rural areas - one in Neath Port Talbot, one is Powys. One example is Dr Julie Lethbridge and Partners in Neath. It comes down to their inability to recruit partners - and remaining partners can’t cope. Even the good ones have difficulty recruiting, and it causes a domino effect.’

In Essex, there are similar problems with recruitment. Dr Brian Balmer, chair of Essex LMC, said that there were two that were under threat. He said: ‘It’s because they can’t recruit. The key reasons so far are the changes in finance and that people are leaving for various reasons - retirement etc. - and they can’t recruit.’

In Oxfordshire, NHS England has said it is closing the Wootton Surgery on 31 August because its premises was not fit for purpose. It said:  ‘The surgery, which only opened for five hours per week, would have needed considerable investment to bring it up to the standards required by the Care Quality Commission (CQC).’

Dr Robert Morley, executive secretary of Birmingham LMC, said there were two practices that had closed in his region. He added: ‘We’re going to see more and more of this. The only way to safeguard the profession and safeguard these practices is for partners to merge.’

Last year, an FOI request by Pulse revealed that 99 practices had closed between 2010 and 2013.

Readers' comments (61)

  • Una Coales

    The question to ask is why has this government chosen the US HMO model over the Australian semiprivate healthcare model? Were there any generous US health insurance party donors? Were there any deals made between number 10 and US healthcare giants or other conglomerates? We can understand why they want to hand over £110 billion a year public debt to privatisation but why the HMO model of salaried GPs and NPs?

    Unsuitable or offensive? Report this comment

  • Una Coales

    I must be getting close to the truth.

    Why did the Coventry consultant anaesthetist BMA chair Mark Porter interrogate only me for 45 minutes in May at BMA House on my wish to put in an emergency motion or council motion on a ballot on strike action by GPs against a financially unfeasible NHS contract that was bankrupting GP surgeries even before my role as council member was to be ratified at the AGM in June?

    Why was I left feeling intimidated and bullied by the BMA for seeking to present GPs concerns about this NHS contract/NHSEng demands driving GPs out?p
    Why did they reject my emergency motion at the ARM in favour of a debate on a BMA bear toy?

    Unsuitable or offensive? Report this comment

  • This comment has been moderated.

  • Una: there is no doubt you have more insight and backroom discussions/threats/gossips. Its the job of all the GPs who are a BMA/RCGP to discuss and be honest on the hidden agenda the government has on GP future.
    the discussions of USA model and other big private providers have been around for sometime and for them to work we need to all be salaried GPs

    Unsuitable or offensive? Report this comment

  • No Una, forget the conspiracy, I'm no BMA/RCGP rep. I'm just a rank and file first 5 GP getting on with the coalface. I have no issues with your lobbying for more funding for primary care but find your desire to bring the CSA issue tiresome.

    This is especially true because several of my IMG colleagues in my year failed CSA and decided to blame the college rather than themselves, because we, the rest of the group who practiced with these trainees could all see that they were not going to pass. Who did they use as proof of the conspiracy? You.

    You have now become a rallying point for substandard trainees who face supposed discrimination. The true discrimination, in my eyes, is not that they were black or Asian or white, its that they were substandard.

    The sad truth is that these trainees face 13 different examiners of all faiths and nationalities, 13 different actors and yet they fail over 4 sittings. There is little chance of conspiracy. There is only borderline candidates who were probably not good enough in the first place.

    And yet, for example, women are far more likely to pass the CSA. Are you suggesting the CSA is sexist too?

    I don't really rate your anecdote about a cambridge graduate failing. Your problem is that you think everyone should pass. I think differently in that the exam is one of competence. Those who fail do not pass the competencies for the RCGP curriculum, simple as that.

    In terms of 124 graduates. I really would like to see equal number of our graduates go to India, practice for 3 years and come out with a CSA equivalent. I bet you less than 124 would do so.

    The true irony is that other countries have no such qualms about IMG pass rates. Our overly politically correct culture and abhorrent at even the mention of the racist word makes us bend over, and are the only reasons that the pass rate is even under debate.

    Unsuitable or offensive? Report this comment

  • well done mr hunt
    you are a failure

    Unsuitable or offensive? Report this comment

  • Una Coales all NHS GP partners facing bankruptcy should watch this clip of a singlehanded GP in North Carolina who underwent similar nightmare tick box bureaucracy, CMS inspection (like CQC and NHS Eng) and finally had to close her practice in rural NC due to stress and bankruptcy. Government overregulation is to blame!

    Allow semiprivate practitioners autonomy to treat patients in peace. Alas in countries with a huge national deficit, govt public funding is tightly ringfenced and that includes any public state funded healthcare like NHS or medicare/medicaid. To work in such a public funded system in the context of a national govt deficit will always be stressful.

    Unsuitable or offensive? Report this comment

  • Una Coales

    @9:33 I am sorry you did not help your IMG GP trainees even when you 'knew' they would fail. I did help IMG GP trainees by teaching them how to control unconscious bias when forced to sit an exam behind closed doors with only one examiner and not 2 to reduce observer bias, an exam with no CCTV recording to challenge at appeal, an exam which fails 4x more British BMEs than white UK grads.

    I have had the pleasure of seeing IMGs achieve a resit CSA score of 95 and 101 after a one day CSA course. This score is even higher than some UK grad scores. I have seen an IMG go from 55 to a score of 85 after one day of learning how to control unconscious bias against IMGs, a belief that IMGs or foreign training is substandard.

    I see IMGs as geniuses and boost their self confidence which has been damaged by beliefs from colleagues that they are substandard. I am an IMG and proud to be one. I am also a British born BME and proud to be one.

    I have fought for exam fairness for IMGs because I know that before the CSA changed its format in Sept 2010, more IMGs passed and fewer white UK grads passed. I know that CSA can be improved once the RCGP acknowledges unconscious bias, tests for it and applies controls as is done in America since 2007.

    The past president of the BMA is an IMG Indian. The past chair of the RCGP Mayur Lakhani is an IMG. IMGs are NOT substandard because they are forced to sit an exam behind closed doors with just one examiner per station. Make the exam fairer and you will ensure the public that you have not passed substandard white UK doctors who passed due to positive unconscious bias or strong unconscious racial preference for whites or failed bright IMGs due to strong unconscious racial preference against foreigners.

    Unsuitable or offensive? Report this comment

  • Anonymous | Sessional/Locum GP | 05 July 2014 9:33pm

    women are far more likely to pass the CSA. Are you suggesting the CSA is sexist too

    Remember when it was the opposite way round it was considered sexist and exams across the Uk were changed from GCSE upwards to 'correct' for this. Interestingly this analysis has ceased now the exam does favour women.

    Of course internationally validated exams (unlike the csa) seem not to have these issues.

    The CSA is the outcome of a politically correct culture.Its laughable to think of a College exam based upon actors and linguistic theory rather then medical knowledge. The CSA has no evidence behind it to say it improves or is an accurate measure of clinical skills.

    I suspect you'll remain a locum for your career with your complete lack of insight

    Unsuitable or offensive? Report this comment

  • Una, I have never said that IMGs are all substandard. I have worked with, helped train and pass CSAs for several IMGs. Many IMGs are excellent clinicians. However, what I do not like are those IMGs who are substandard to hide behind racism as some kind of excuse. It isn't.

    And I'm afraid you have been responsible for pushing the political corrrectness completely the other way. I'm sure I'll get heckled by IMG registrars for being racist just for expressing my opinion, hence the anonymity.

    Unsuitable or offensive? Report this comment

  • Anonymous | GP registrar | 06 July 2014 6:34pm

    "I suspect you'll remain a locum for your career with your complete lack of insight"

    Is that some kind of insult? What are you, like 5 years old? Because its pretty weak.

    In terms of the rest of your rant....

    If you want to talk about lack of insight, you should evaluate your idea that the CSA should be knowledge based.

    I'm not sure if you've sat the CSA or passed it or not, but you've obviously missed the nuts and bolts of general practice: 75% comms/psychosocial, and 25% knowledge.

    Incidentally, knowledge is already tested at the AKT.

    If you want to send a reply insult, please try a little harder.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say