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Independents' Day

‘600 practices will close’ without funding boost, warns BMA

More than 600 GP practices will close in England if the Government fails to increase funding for general practice, the BMA has said.

In its analysis of NHS England’s GP Forward View, the BMA’s GP Committee said that current funding for general practice is £3.7bn short of its target of 11% of the NHS budget.

This is despite NHS England’s plan for an investment of £2.4bn a year in general practice by 2021 when it was launched two years ago.

The BMA’s report called for a ‘wholesale review’ of the GP Forward View, with GP leaders saying the profession remains ‘in critical condition’.

The GPC’s practice closure projections estimate that, based on past rates of decline, England will lose between 618 and 777 practices between now and 2022.

The report said: ‘Partly this will be due to mergers but many of these losses will be due to continued pressures on general practice.’

This comes after a Pulse investigation revealed that 1.3m patients have been displaced due to practice mergers and closures since 2013.

Quoting Pulse’s investigation, GPC chair Dr Richard Vautrey said: ‘We have seen the devastating effect of practice closures over the last few years, with more than a million patients displaced since 2013, and now this analysis paints an even bleaker picture for the future.

‘Patients already face unacceptably long waits for appointments, and without urgent government action and significantly more investment this will only get worse as millions more are left without a practice and struggling to find a new one.’

A spokesperson for the Department of Health and Social Care said: ‘There are a number of reasons why GP practices close - they may merge with other practices in order to improve services to their patients or GPs could retire from single-handed practices.

‘But we recognise the everyday pressures facing GPs and that’s why we’re increasing investment by £2.4bn a year by 2021 and are determined to recruit 5,000 new doctors to grow a strong and sustainable general practice for the future.’ 

However, the report added that it is ‘not clear whether recurrent GPFV funding is on track’ as current investment in ‘general practice falls £3.7bn short of the BMA’s target of 11% of the NHS budget’. 

The BMA’s report said: ‘There is a strong case for undertaking a wholesale review of the GPFV, and current discussions in Government about establishing a long-term funding settlement for the NHS provide an opportunity to put in place a much more substantial package of measures that prioritises getting recurrent funding into frontline care.’

The Prime Minister announced in March that she is looking at a longer term, ‘multiyear’ NHS funding settlement, which is set to be finalised this year.

Dr Vautrey said: ‘Overall, our research provides further evidence that general practice remains in critical condition.

‘It does not have to be that way, however. The Prime Minister has pledged to lay out a long-term funding plan for the NHS later this year, and she must use this opportunity to tackle the decade of underinvestment in general practice.’

The BMA’s review comes after Pulse completed its own analysis of the GP Forward View in April.

NHS England's analysis concluded that progress against the plan was 'on track', including thousands of practices going through the resilience programme.

In an opinion piece submitted to Pulse, primary care director and deputy medical director Dr Arvind Madan also said they are now 'beginning to see some of the fruits' of the investment.


Key findings from the BMA’s GP Forward View analysis:

  • While more GPs appear to be entering training, GP recruitment still falls short of the annual recruitment target initially set in 2015/16 and remains well short of the number needed to replace those GPs leaving the profession.
  • A number of workforce initiatives – including the Targeted Recruitment Scheme, the GP Retention Scheme, and the Induction and Refresher Scheme – are having some positive impact, but processes need to be streamlined and funding made recurrent.
  • Securing funding to enable improvements to practice premises has been difficult, with many infrastructure schemes delayed.
  • Funding to enable online consultations has not been reaching enough practices.
  • Overall, GPFV is struggling to deliver on its commitments. Across general practice, there is a widespread view that it does not go “far enough, fast enough” and after two years it still does not have the confidence of GPs.

Source: BMA

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Readers' comments (9)

  • Not in Medway, here they will be taken over by one friendly APMS Provider without tenders or consultations at £145 per patient and additional undisclosed payments. Just like St Mary's Island Surgery recently. Resourcefulness or corruption, it works - only not for ordinary run of mill GPs who are outsiders and not worthy of such funding.

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  • Its almost as if they want us to fail.

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  • They want us to fail. Our funding per patient is only half of what APMS gets.

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  • We would all be very surprised if there is not an announcement of sustainable funding for the NHS on the anniversary in July of the founding of the health service. The question is how will this extra resource be spent? Do we invest in primary care and therefore intervention at an earlier stage of disease and in preventing people from getting ill in the beginning, or do we continue to focus resources on increasing hospital capacity. The five-year forward view in many ways held some of the inspirational visions developed by Bevan and Beverage. What is our 70 year view?

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  • Does the government really care even though JH has admitted that he’s struggling to recruit 5000 extra GPs by 2020. It’s not just that they want us to fail but that it’s guaranteed the way things are going.

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  • small practice closure is part of their plan.

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  • AlanAlmond

    “The Prime Minister announced in March that she is looking at a longer term, ‘multiyear’ NHS funding settlement, which is set to be finalised this year.” what? All that is likly to mean is possible more money for hospitals. General practice doesn’t require funding apparently, just wholesale yearly reorganisation, greater efficiency and different staff. The NHS is hospital care and a&e, all you have to do is switch on the news to work that one out.

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  • Unfortunately there are many poorly run practices. BMA handwringing should not be mistaken for useful activity; the BMA's hostility to charging patients is part of the problem.

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  • GP land is so riven with injustice that it needs to end in its current form.
    APMS get 25-50 % more than GPs on GMS.
    Even GPs on GMS has this huge variation. Some get 100, others 200 [ even 500 in specific practices].
    Of course, there will be some variation for different locations and groups, but currently it is just crazy.
    2000 GPs need resilience funding [ seeing 40+ patients a day]
    The system is so broken that the sooner the whole thing goes under, the better.
    But GPs are so altruistic, this will not happen.
    They will continue to work amid all the injustice, CQC, Complaints, manslaughter,litigation and so on.

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