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At the heart of general practice since 1960

One in 20 GPs considering closing their practice by next spring

Exclusive One in 20 GPs is considering closing their practice within six months, in the latest indication of the drastic action the profession is considering to survive.

A Pulse survey of nearly 600 GPs found 5% were thinking about handing back their contracts to NHS England within six months.

Nearly 13% said they could not see their practices remaining viable beyond the next two years.

The survey reveals the deep uncertainty within general practice, with GPs citing overwork and burnout as reasons for them considering giving up their contracts.

One in ten (12%) said they were considering applying for a temporary list closure, while 15% said they were thinking of shrinking their practice boundaries.

And many GPs admitted to having to make staff cutbacks to stave off closure, with 16% considering redundancies among their admin staff and 13% thinking of making cuts among their clinical staff in the next six months.

GP leaders told Pulse the survey results were ‘sadly, all too common’ and indicated that NHS England’s Five Year Forward View proposal for an emergency package for general practice may come too late for GPs who are at the ‘end of their tether’.

The latest figures come as Pulse continues to campaign for emergency support for struggling practices and major increases in long-term investment as part of its ‘Stop Practice Closures’ campaign.

The RCGP said last month that more than 500 practices in England could close within a year because of a ‘deepening crisis’ in the recruitment and retention of GPs, and a Pulse investigation revealed in July that 100 practices had closed or were facing imminent closure.

The results of the survey of 564 GPs found:

  • One in 10 are considering applying for a temporary list closure in the next six months
  • 15% are considering shrinking their practice boundaries
  • Nearly 4% see their practice viable only for one year max, and 9% for one to two years
  • Only one third can see their practices remaining open for 10 years or more
  • One in 10 are considering making clinical staff redundancies
  • 15% are considering making administrative staff redundant
  • 24% are considering cutting staff hours in the next six months
  • A fifth of GPs may cut routine appointments
  • Nearly a third (30.5%) will consider discontinuing some clinical services
  • 15% are considering merging with other practices

Dr David Marr, a GP in Dukinfield, Cheshire, said he would be retiring early from his practice in April 2015, leaving his partner to manage alone and that he expects the practice to close within the year.

He said: ‘[There’s a] lack of enthusiasm for partnerships amongst trainees. The BMA standard contract makes salaried GPs (with all the benefits and no responsibility) too expensive.’

Dr Agnelo Fernandes, a GP partner in Croydon, said that he would be handing his contract back to NHS England due to a ‘serious loss of funding’.

And Southampton GP Dr Alan Mayers said: ‘[It’s] getting harder and harder to meet all the demands, and we can’t recruit. With falling MPIG, running two sites is going to be financially very difficult.’

GPC deputy chair Richard Vautrey said the results showed a reality that was ‘all too common now’. He said: ‘They reflect the growing workload pressures and real stresses that GPs are under. And it’s not a surprise that many GPs have reached the end of their tether and taking very difficult decisions.

‘The NHS Five Year Forward View that was released last week, it was talking about stability of funding in the next two years and increased investment in primary care in the next five years, we need to see that much, much quicker to enable practices to support the core work they’re delivering.’

Are you considering the following within your practice over the next six months?

Practice closure pie charts

The survey  launched on 7 September 2014, collating responses using the SurveyMonkey tool. The 29 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to readers via our website and email newsletter, with a prize drawer for a Samsung HD TV as an incentive to complete the survey. Some 564 GPs answered this question.

 

Related images

  • Stop Practice Closures-logo-online-330
  • Closed - shut door - padlock - doors


Readers' comments (20)

  • Peter Swinyard

    The Five Year Forward View (and I would beg the commentariat not to comment unless they have read the full document!!!!) actually does have some promising ideas in it and recognises that we are under strain.
    Unfortunately, what we need is an invigorating infusion of resources into practices NOW to prevent closures rather than steadily over 2 years, by which time it will be too late for many practices to continue and for many patients to have the continuity of care they need and desire.
    The challenge to the government is simple. You have to invest now to save later. Destroying general practice will be a deeply expensive (in human and financial terms) disaster for which your political party (of whichever hue) will never be forgiven. Sticking plaster won't do. We need serious money now and should not be afraid to say that the job weight, complexity and responsibility of partners in general practice should be properly rewarded to keep them in their practices rather than seeing that they could earn more as a locum/salaried doctor/out of hours doctor/expatriate without the burden of running a business and investing in property and staff.
    Time for action, not just more words. We need visible commitment with money actually appearing in the bank accounts and balance sheets.
    On a personal level, not only have I taken a 20%+ pay cut in the last 5 years but have recently had to put £7000 into the practice from my personal account to keep the cashflow ticking over.
    Do consultants or salaried GPs have to do the same???

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  • The writing was on the wall few years ago, this is called "unintended consequences", I agree that the BMA salaried GP model contract is outdated and does not reflect on the current financial status, who in the right mind is going to take a salaried GP (on BMA model) while seeing own work increase and finances decrease! Along with stress related illnesses?

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  • It seems perverse that the most efficient part of the NHS is being destroyed.

    However my one criticism of GP's I meet is that fare too many are self sacrificing - whereas younger GP's with big debts cannot afford to be.
    By sacrificing you own salary , taking paycuts you assume governments will listen to reason. Unfortunately thats not how it works. Its not clear if destroying GP is deliberate or just incompetence ut the solutions have been there for some time. Your practices need to work within budgets.

    I've been in companies where income falls - what happens - major drop in service etc
    What GP's in UK keep doing - is as income drops they work harder and harder to keep up service levels. saintly but pointless - no-one sees your super human efforts and you destroy your selves in the mean time.

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  • The salaried GP model leaves the GP at whims and fancy of National health England with their non evidence based medicine,irrational funding cutbacks and looming disaster for the dedicated hardworking GP

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  • I could agree with Josh any more strongly. The system is being held together by goodwill and unfortunately people (patients) do not get a good idea of what is happening underneath. Sadly the only way that things will change is when practices and the service more generally is allowed to fail

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  • The main resource needed is medical manpower, money alone won't solve that equation. Employing more nurses, doctors assistants etc will not maintain the quality of care and the Daily Mail will have a field-day.
    It looks as if the DOH have decided to let General Practice sink into oblivion and this concept will not attract many recruits.

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  • Bob Hodges

    "Unitended Consequences"

    a.k.a What anyone with more than half a brain could have easily foreseen, if anyone had even bothered to ask someone with more than half a brain in the first place before launching feet first into the next political vanity-project.

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  • I'll add to what Josh has just mentioned- The tragedy with some bigger Practices in our region has been that they have tried to take on extra work (ex Unplanned admissions) to recover some funds that have been lost.
    Unfortunately, this has backfired and brought them to the brink of closure because the work was loaded on to salaried GPs who left irked and then some of the Partners who had the burdens thrown back at them also decided to disperse.
    Sometimes, it's sensible to say enough is enough and not go for every penny thrown at you.

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  • GPs have got to learn to STOP looking at the top line and concentrate on the BOTTOM line. No point spending £6 to earn £5

    Start cutting back services for all the reasons out lined above. You all know that the Grand Canyon was formed when someone dropped 10p in front of a busload of GPs

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  • "GPC deputy chair Richard Vautrey said the results showed a reality that was ‘all too common now’. He said: ‘They reflect the growing workload pressures and real stresses that GPs are under. And it’s not a surprise that many GPs have reached the end of their tether and taking very difficult decisions.

    ‘The NHS Five Year Forward View that was released last week, it was talking about stability of funding in the next two years and increased investment in primary care in the next five years, we need to see that much, much quicker to enable practices to support the core work they’re delivering."

    And what are you doing about it GPC? Writing a strongly worded letter to the under-secretary's deputy assistant bag carrier? Oooo, JH will be so scared!
    When will GPs all resign en masse from the GPC that keeps refusing to fight or to consider alternatives to the state funding? No union in world history has been this bad to its members.

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