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Independents' Day

NHS England must be held accountable for every practice closure, says GPC chair

NHS England area teams must be mandated to ensure that none of its GP practices close, and must declare a significant untoward incident every time it does happen, the GPC chair has said in a passionate speech to the LMCs Conference today.

He also said that ’mass resignation is not just a threat, but an impending reality’, warning that GPs are already leaving the profession. 

Dr Nagpaul said that seven-day services were ‘immoral’, and praised NHS England for not focusing on weekend opening in its General Practice Forward View.

The LMCs Conference will debate tomorrow morning whether they will still push for GPs to submit undated resignations, as agreed by the Special LMCs Conference in January.

But Dr Nagpaul said that the numbers of GPs set to quit in the next five years means that it is no longer a threat, but a reality, regardless of tomorrow’s vote.

He said: ‘With government figures stating 38% of GPs intend to quit in the next 5 years, mass resignation is not a threat – it’s an impending reality. The Government must ensure we retain the current workforce, in particular tackling the perverse factors driving older GPs to leave early.’

Dr Nagpaul also focused on the issue of practice closures, referring to the £40m ‘resilience programme’ announced in the Forward View.

But he said that NHS England local area teams must be held accountable for practices closing.

He said: ‘It should be a significant untoward incident and a failing of the local NHS if any practice needlessly closes. This creates disruption and displacement of essential family doctor services to patients, and the domino effect of instability on neighbouring practices, not least wasted costs to the taxpayer of re-providing the service.

‘I therefore call upon NHS England to use the Forward View’s practice resilience programme to make it an explicit KPI for all Area Teams to ensure there’s not a single unnecessary or avoidable practice closure now or in the future.’

He pointed towards federations as a way of preventing practice closures, and said moves to collective working have helped practices stay afloat.

He said: ’Now is the time to resurrect that spirit of collectivism and mutual support. We need development funding for an in hours cooperative movement, and pull together in local communities as one GP profession.

’We’re seeing examples of this working already-in one instance a practice about to close after losing two partners was kept afloat by employed doctors in the local federation and is now back on its feet. In another example a federation’s urgent care hub was able to support a practice unable to cope due to GP illness.’

Dr Nagpaul highlighted NHS England’s plans for local commissioners to decide the level of routine capacity at evenings and weekends, and welcomed the flexibility that this offered.

But he added: ’It’s not gone far enough, but in the context of a manifesto pledge that formed the basis of the Government’s intransigence with our junior colleagues, we may have partly won the argument.

’Of course politicians will resurrect the seven day agenda but it’s vital that we hold NHS England to account to their words to ensure that the priority for seven days is where it should always be - for properly funded urgent care and GP out of hours services, and we must reject the immorality of taking GPs away from caring for acutely ill patients to sit in empty surgeries superfluous to need.’

For full coverage of the LMCs Conference please visit our dedicated page

Readers' comments (17)

  • Even if there is no mass resignation.What will happen is the atrophy of primary care as the current 50/40 somethings decide being a GP/principal is not worth it and they "RELP".Is it too late,by the dearth of youngsters applying for post YES!

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  • The usual rousing but ultimately meaningless speech by Chaand which will result in absolutely nothing being changed. Unless you act, it is all hot air, and for years the GPC and LMCs have refused to act, time and time again.

    Hot air Chaand.

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  • So ballot us. We're ready Chaand. Are you?

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  • Yes, so ballot us

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  • Do a dentist. Get on and ask us.

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  • Why stay as a partner?
    Earn less than salaried doctors you employ, but have the responsibility of running a business with income being slashed and workload rising. Paying staff, concern re premises including renewals and repairs with costs rising more than income, Increasing shift from secondary to primary care with inadequate community and mental health services. Worries about CQC and targets. Concerns re pensions and annual limits, with decreasing LTA. Soaring indemnity costs. Burnout through complete lack of support. Media doctor bashing, and fear of making a mistake when overworked and tired. Not to mention annual appraisal and revalidation. I can honestly say that I have felt far less stressed since I took my pension and resigned as a partner at the end of 2014. I am however seriously worried about what kind of NHS there will be for me soon.

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  • let ask pulse to start campaign to ask for ballot of every GP in country and not just few and see is there a real appetite amongst us or only few of us who are asking for it. I hope pulse editor is reading this.

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  • Dear Pulse Editor,
    Dr Bhahalkar's idea (see 11.04am) is an excellent one.
    However, for the ballot to have maximum impact, thousands of GPs would need to vote.
    Could you (if you agree with the idea) advertise the ballot in advance and then keep the ballot running for at least two weeks, allowing any GP who reads Pulse on line, to vote.
    It is very encouraging that you seem to have Simon Stevens ear.
    A large majority in favour of mass resignation might concentrate Simon Steven's mind on prioritising reviewing the Carr Hill formula, as he has promised to do.

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  • None of this addresses the reality that resignation will lead to rapid bankruptcy for many GP partners due to their legal obligations for staff and salaried GP contracts, lease payments, indemnity cover and premises rates.

    None of these obligations weighed so very heavily on doctors in 1966.

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  • Dear Anonymous at 12.14,
    Don't forget that patients will still need doctors . Doctors will need staff /premises/ as business will be run but bit differently. Yes there may be some streamlining and some redundancies. There will be uncertainty but at least we will be able to dictate how we work and how much we get paid. Dentists have done it.
    We only provide service. Who pays for it is not our concern. Our concerns should be are we providing good service? and Are we getting paid for it appropriately? and most importantly are we happy in our jobs?

    Time has come to take control of our life and our work & let not some stupid person who has no idea of how we work /how much we work & does not recognise our worth make decisions about our work and lives.

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