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More than 500 GP practices have closed in last five years, 'stark' Government figures reveal

More than 500 GP practices have closed since 2009/10, the Government has admitted, in what GPC has described as a ‘stark’ indication of the crisis facing general practice.

Health minister Dr Dan Poulter revealed in Parliament that the number of practices closing has increased dramatically since 2010, when 79 practices closed, compared with 2014, which has already seen 78 practices closing up to 31 August.

Overall, 518 practices have closed in the period, including 126 in 2013 and 124 in 2012.

Dr Poulter provided the figures in response to a question from Edmonton MP Andy Love, who had asked about closures in England, London and in his constituency area of Enfield, London. Mr Love has also given his support to Pulse’s Stop Practice Closures campaign.

The figures showed that in the same time period, 110 practices opened, meaning there was just one new opening to every five closures. This year to date, there have been nine new practice openings.

Pulse has reported this year that LMC leaders had been approached by more than 100 practices who were considering closing due to reduction in funding and recruitment problems, and as a result started the Stop Practice Closures campaign.

The new figures also seems at odds with figures provided by NHS England in response to a freedom of information request by Pulse, which revealed that 99 practices had closed in the past four years.

Dr Poulter emphasised that these latest figures ‘also include practice mergers and takeovers and do not provide an accurate representation of activity or service provision’, adding: ‘In many cases, practices listed in these figures as having closed, will have in fact merged and will continue to see patients.’

An NHS England spokesperson reiterated the position, adding: ‘NHS England aims to ensure that all patients will be able to register with a GP.’

But GPC negotiator Dr Beth McCarron-Nash said: ‘It is stark. I think that general practice is in crisis and need urgent negotiated solutions and obviously we continue to lobby NHS England and the Department of Health to address the fundamental problems that GPs are facing.’

‘There has been no premises investment since 2004, there is constant change to the NHS, including the hand grenade that has been the Health and Social Care Act, a disinvestment in GP practice, a disinvestment in the contract and the fact that they have not had a national workforce strategy to actually solve the fact that over 25% of GPs are over the age of 50, and that along with the catastrophic changes to the NHS pensions scheme.’

‘I think all of this is a perfect storm for a GP to say “listen, I’ve had enough”, and the other thing I’ve missed off the list is the increasing levels of bureaucracy, such as the CQC etc.’

Please note: this article was changed at 11:56 on 11 September 2014 to reflect that there was one opening every five closures, not one every 21

 

Practice closures and openings 2009-14
 EnglandNHS London areaEnfield Clinical Commissioning Group area
 ClosedOpenedClosedOpenedClosedOpened
20107955122100
20111111921601
20121241431470
20131261339520
2014 (to 31 August)78914430
Source: House of Commons Hansard

 

 

Readers' comments (37)

  • Blame The Daily Mail (one of Jeremy Hunt's "Henchmen" and "enforcers"), Jeremy Hunt (for his "political thuggery") and The DOH for "complicity" in bullying and thuggery. They created this mess and have let down the general public.
    Hunt should now do the honourable thing and RESIGN, just go Hunt.
    Maybe they will give you a job in Scotland ? (not)

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  • I fully agree with 9.40am.
    Trouble is The Daily Mail is "in too deep" with Tory Chums to now be honest with the electorate.
    This is what the CIA call "blowback".....unintended extreme consequences of certain interventions.

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  • This will be answered in the media with yet more "politically violent attacks" on GPs to cover up for the real blame-which is the "malicious failure of the government to face the facts".
    Hunt will be on the phone as we speak to his "dinner party friends" at The Daily Mail.

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  • I think the Scots decision to part ways may be to a great extent dictated by their reluctance to tow the UK govt's line on NHS services.

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  • 'one new opening to every 21 closures'?
    Surely one new opening to every 5 closures

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  • This has been changed now - thanks for pointing this out

  • I have just resigned, and NHSEng have just closed our 2 rural branch surgeries. Even now, the local, public anger is directed at the "bad GPs" rather than the underfunding and recruiting problems which led to this desperate and unhappy act. Why will no-one accept that State-funded Healthcare is expensive but cheaper than the alternative. (which is a re-do of Winston Churchill's famous quote about democracy being better than the alternatives). The international stats for NHS funding as percentage of GDP are still dreadful. Wake up Daily Mail readers.. this is your country, and anything you don't like is your own fault.

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  • I fully agree with comment at 10.38 - I too resigned from my practice (a semi-rural 2 branch surgery) 2 months ago and am now very happy working as a locum. NHSE have given contract to a private provider on APMS costing taxpayer much more for a much inferior service (they employ locums hence pts see a different dr everytime) - still it was all our fault for leaving the leaving the surgery which led me to a near nervous break-down. This society is spoilt and need a reality check - sadly it will never come from politicans whose existence depends on the votes from society hence the blame will always be with doctors/hospitals etc.

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  • The way NHS is running ,enforcing cheaper but not so cost effective medications doctors for their mistakes in enforcing usage of medicines against Evidence based,like sulphonyureas as shown by Prof Anthony Barnet: when quoting Diabetologia,sponsored by DVLA he states Sulphonyureas lowers sugar like Insulin in the first three years;restricting GPs prescription of Glucose testing strips;National health makes all GPs walk the plank.This why young GPs qualify and move to Australia and New Zealand and older GPs resign to avoid this quicksand created by NHS

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  • Get the Daily Mail to apply for an APMS contract? After all they are geniuses! replace all the GP simpletons with Daily Mail journalists. Anyway, as we are all "scum", why would anybody be angry if we close practices to make way for "real doctors"??

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  • In my area 6 practices all closed and moved into one all singing all dancing fit for purpose health centre. Are these figures included?? (6 closed - 1 opened) I believe we are witnessing, once again, the dreaded scaremongering tactics to panic the masses. Lots of GP's are against "Tory (Mail)" privatisation, but a hell of a lot of them are looking to maximise personal income through selling out their GMS contracts to large "Private" Health companies for personal financial gain. Talk about pot and kettle!! Everyone in the country recognises that the NHS is just not affordable, but no one has the courage to take it face on for fear of losing votes so instead there are lots of behind the scenes scheming going on in order to undermine the whole system whilst placing the blame firmly on the shoulders of others, namely in this case the nasty GP's. The Titanic was Unsinkable, the NHS???? Man the lifeboats, GP's and children first!!

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  • Peter Swinyard

    It was the case that 11%+ of the NHS cake went into primary care.
    It is now 7.5% (just over 8% if you include all prescribing costs)
    It is the case that we in general practice are expected to do ever more with ever less.
    The pips are squeaking and those who can get out are getting out.
    The main incentives for staying are vocational, not logical or businesslike.
    Only for so long can NHSE rely on the vocational nature of our profession. I fail to identify the workforce planning to cope with the retirement demographic bulge over the next 5 years or the impossibility of recruiting even in some quite pleasant areas.
    I think that politicians and bureaucrats alike are having violin lessons while general practice is alight. They are hoping that the crash comes on someone else's watch.
    But we have long memories....

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  • Bob Hodges

    "In my area 6 practices all closed and moved into one all singing all dancing fit for purpose health centre. Are these figures included?? (6 closed - 1 opened)"

    Daily Mail Time!! Hurrah!

    'Practices' are not 'buildings', they are groups of doctors holding a contract and having a list of patients. Putting them in the same building is not the same as 'merging' practices.

    These statistic are also able to tell the difference between a merger and a closure - even NHS England can do this.

    By the way, the fact that doctors moving into new building is such a rare event should tell you something if you think about it.

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  • Peter Swinyard

    incidentally, in reply to 11.00am, GMS (or PMS) GPs cannot "sell out" their GMS contracts for personal financial gain as they cannot legally sell the goodwill of a practice. They CAN sell the goodwill attached to enhanced services, rather bizarrely, if they can find a buyer.....

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  • 11am NHS Manager.
    kettle and black pot comment. If GPs are seeing their business (and vocation) going down the pan, why not allow a private provider to take over, the situation will only end in the same way.....under-funding, closure of practice, lack of continuity owing to reliance on locums.
    If the public wants to 'comsume' the NHS like they do on the high street , then it needs to pay more for its' wants, and accept its' actual needs are not healthcare costs to be borne by the taxpayer!

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  • a lot of branch surgeries in rural areas were opened to get dispensing income and are now unaffordable.

    Surely Pulse is not campaigning to keep every surgery open

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  • This comment has been deleted

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  • @10:38: It is a pity that ordinary people do not see that the GPs are not fault. Anger directed at the GP?
    One would have expected at least some understanding for GPs predicament from the local populace after years of hard work by the individual if not appreciation. Alas, this could seem a thankless job.
    Don't lose heart Doc - for every one that is moaning against the GP there surely are another 5 who do appreciate your effort and devotion. It's just that the happy ones don't voice their opinions.

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  • NHS Manager | 11 September 2014 11:00am
    Obviously NHS managers are as clueless to progressive primary care policy as HSE (Irish) management.
    Larger practices lead to erosion of continuity of care resulting in poorer outcomes http://content.healthaffairs.org/content/33/9/1680 … Personalised care is superior to corporate care with regards to patient satisfaction, reduced unnecessary admissions and general care.
    Corporate care is superior to traditional GP on bureaucratic criteria only, but is much more expensive and a/w poorer outcomes in the long run.

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  • GP Partner 1:22pm.
    I didn't say it was a larger practice, i said that 6 Practices have moved into one building. They are still individual practices providing "personalised" care to their Patient Lists. I was commenting about how statistics can lie ie in our case 6 closed but only one opened. Actually 6 didn't close but moved into 1 shared premises.
    Always a problem when someone misinterprets and then makes it personal!!

    Not sure your word clueless is appropriate in this context but I'll use it anyway. "Clueless!"

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  • Ivan Benett

    In Central Manchester we have gone down from 42 to 35 practices in 2 years. This has been due to practice mergers and retiring GPs> There's nothing sinister about it. The issue isn't the number of practices, but are they able to attract the workforce. So long as Pulse and other journals fill their collumns with moaning GPs it's hardly a surprise that younger doctors don't want to join them. Every advert I see says 'friendly team' but the reality is not bourne out by their interview experiences.
    I'm sure anonynous commentators will rage against these views, but really we have to sell ourselves if we want a wokforce, not denigrate our vocation.

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  • This comment has been moderated.

  • Absolutely spot on Ivan.

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  • Not sure 'nhs manager' understand anything about primary care but what you are describing isn't practice coding at all. It's relocation and as long as you have LAT (do you even iknow what that m&eans?) approves the move, there is no reason to dissolvre the partnership just to relocate. It will therefore not be recorded as practice closure.

    Ivan,

    'In fact we've only lost single handed, aging GPs who mostly should have retired a long time ago.'

    Perhaps you would like to justify your comment. I really feel sorry for Manchester GPs.

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  • Bob Hodges

    Jesus Wept Ivan.

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  • I'm sooo glad I don't work in Manchester

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  • does ivan ever say anything sensible?

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  • What is the IQ of a average journalist? 3 Bs at A level. A bunch of rabid people with no regard to fact for their opinions, which are flawed due to their lack of intellect, anyway. Unfortunately, we do not have people like Brian Cox in journalism. The truly bright folks do astrophysics and law and finance etc. We have a bunch of people with low IQs, but with a knowledge of the English language, dictating policy through their mostly dumb opinions.

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  • Where the hell did the above comment come from? What has a journalist said or done on this forum to make that an acceptable comment?
    3 Bs at A level ( if that's what is average) is way above the national average.
    My daughter is a journalist. 3 As at A level and a distinction in her masters. Her boyfriend, also a journalist has a high degree, masters and speaks 4 languages fluently.
    Sadly your comment says more about your knowledge intellect and attitudes than anyone else's. It does nothing to help the very serious problems faced by GPs and their patients.

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  • Ivan,
    You say that the number of practices in Manchester has gone down by 7 in the last 2 years and that this is mostly due to single handed, older, practitioners who should have left years ago.
    These (maximum of) 7 doctors should be very easily identifiable. If I were one of them I would be seeking legal advice. It is not acceptable to slag off your colleagues without stating facts and evidence. What's is your evidence, other than the fact that these were single handed doctors who did not fit your political ideology?

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  • Its funny how Ivan is the only one who has a different agenda to the rest of us GP's. Tells the story I think!

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  • Ivan, as a central Manchester GP I find your comments completely inappropriate.

    I've personally known many of these "should have gone long time ago GPs" and many provided exemplary care.

    And truthfully? Many merged due to pressure from PCT or inability to find suitable replacement partner.

    You do the whole profession a huge disservice when you make such wild statements. Your comments will have repercussions.

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  • Those GPs who should have 'retired long ago' have stayed on and faced the continuing pile of poo that rains down on them from government , patients expectation and now their own collegues- they need our support and thanks. Yes some may not have been up to the 'standard' of what the newbie 'go getters' HMG brown nosers want but they were building primary care when some of us were reading Beano under the sheets with a torch.
    I for one salute them and may Dr IB re-read and feel shame at his comments

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  • Ivan,

    I suggest you read the following extract from GMC guidance

    Respect for colleagues
    15. Good medical practice says that doctors must treat colleagues fairly and with respect.* This covers all situations and all forms of interaction and communication. You must not bully, harass or make gratuitous, unsubstantiated or unsustainable comments about individuals online.
    16. When interacting with or commenting about individuals or organisations online, you should be aware that postings online are subject to the same laws of copyright and defamation† as written or verbal communications, whether they are made in a personal or professional capacity.‡

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  • 11am says the NHS is not affordable. Hmm.
    In UK and most developed countries, the health systems are considerably more cost-effective than the alternatives. If everyone who got sick either became a burden to their family or died, where would our economy be? If the state didn't look after our old people and our very young, economically active adults would take time out of the workplace to look after them. A more modern example from USA, Kaiser Permanente, has been able to put figures on this - the construction company Kaiser created a healthcare arm for its own staff - simply because it is more profitable to provide good healthcare and keep people working than to leave people to suffer.
    NHS comes top in the 2014 Commonwealth Fund survey of health systems in developing nations (and has come near the top in each of the last x surveys).
    Yes I know it's underfunded compared with need. What I'm saying is that it is cost-effective and valuable, and if we put even more money in, it would still be cost-effective and valuable. To cut funding is short-sighted.
    As for GP practices - Teisberg & Porter (2004) demonstrated in a very simple chart that USA states with a GP-led system were much lower cost and at the same time much higher quality of care (patient outcomes) than USA states with a hospital-led system. So USA is trying to be like UK NHS. Why are we trying to be like USA - beats me?

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  • In regards to Ivan's comments;


    1) 'In fact we've only lost single handed, aging GPs who mostly should have retired a long time ago.' - a lot of us thanks to the bankers have got to work on to 70. So I'm curious as to the age of the GPs you are refering to?

    2) So long as Pulse and other journals fill their collumns with moaning GPs it's hardly a surprise that younger doctors don't want to join them. Many of us call a spade a spade and are not puppets on strings. It is only fair that the younger generation are aware of what is actually going on and not what is spun by our 'leaders'.

    3) Every advert I see says 'friendly team' but the reality is not bourne out by their interview experiences. I agree with you on that one.


    4) I'm sure anonynous commentators will rage against these views, but really we have to sell ourselves if we want a wokforce, not denigrate our vocation. Being a doctor is fantastic .... just not in the UK.

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  • Ivan
    I also notice that you are listed as a salaried GP. You therefore do not have the same legal and financial responsibility for running a practice as a partner. If it is all so wonderful, why are you not a partner?

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  • Anonymous | GP Partner | 12 September 2014 4:06pm

    Ivan is a partner in Whalley Range in Manchester. I believe he's on the CCG board, which makes his comments even more unprofessional.

    There is a case here for his removal from the CCG.

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  • If he is on the CCG board, does that mean that other GPs in Manchester voted him in?
    I would be interested to hear from other GPs locally what they think of Ivan's ideas ( but not personal comments about him!)

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