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Independents' Day

Pulse 2019 review: Practices closing in record numbers

A Pulse investigation revealed the growing number of practices closing their doors. Allie Anderson reports

Practice closures continued to hit the headlines in 2019, with 12 surgeries shutting up shop in January alone.

This compared with just eight during the first month of 2018, and added to the almost 140 in total that year. The stark reality was unveiled in a Pulse investigation in May, and showed just how bad things had got.

Pulse’s figures, gained through freedom of information requests, revealed that the 138 closures in 2018 had displaced more than half a million patients, many of whom had to be taken on by other, nearby practices, adding to their own strain.

There was little room left for doubt that measures aimed addressing diminishing practice numbers were doomed to failure. NHS England’s ‘resilience fund’ for vulnerable practices is one such example.

The numbers follow a worrying pattern. Between 2013 and 2017, 445 practices closed across the UK, affecting almost 1.5 million patients.

Patients are destined to suffer, especially in the hardest-hit areas of the country.

The impact of yet another practice closure in Brighton – the 13th in just four years – is that elderly and vulnerable patients might effectively be unable to get to see a doctor, thanks to the steep hill and distance they now face to get to their new surgery.

And the effect on neighbouring practices in places like Brighton is immense. Take Plymouth for instance, where adjoining surgeries to some that have closed are handing back their contracts, unable to cope with demand.

Nationwide, almost 90% of practices that closed in 2018 had lists of fewer than 5,000 patients, playing into the hands of those in power who are encouraging bigger practices.

This greater emphasis on large practice groups plays out in the form of primary care networks, each covering 30,000 to 50,000 patients, which were mandated in the 2019 GP contract.

We’ve heard tales of practices battling hard to buck the trend, yet their chances of success are bleak. One practice in west Wales faces closure after three years without a single GP, and providing only nurse sessions.

Countless others will see in the New Year unsure how long they have left before succumbing to the growing pressures.

If current trends continue, however, even more could be putting up their ‘Closed’ signs for the final time.

Readers' comments (9)

  • All going according to plan then.

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  • Vinci Ho

    This number of GP closing their doors should be coupled with the decline in total number of full-time equivalent GPs and seen as a whole trend.
    As I wrote before , this is the inevitable scorched earth phenomenon in our confrontation with this government so far . Whether this will carry on or worsen , it is now up to this government and its health secretary (as well as its propaganda media and essentially , regulatory bodies) .
    The reality after the result of general election is , Brexit is to happen end of this month . How much the post-truth politics will affect BMA and RCGP ( both were officially declaring Remain stance) in future battles against the government remains to be seen. . Obviously , the PM has already drawn the deadline of 31/12/2020 for the end of transition period legally . If no trade deal could be agreed with EU before the deadline , No-deal is the endgame.......
    While Brexit probably has evolved with a bit more clarity , we(GP) are facing more uncertainties with our new five year contract characterised and dominated by the ideology of primary care network (PCN) : ‘ Big presumably is better than Small’ .

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  • A sad situation caused by lack of the 5 Ps by governments
    I am ashamed to be British

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  • Vinci Ho

    The PM could argue that he was beleaguered by the parliament BEFORE this general election . Now he cannot .
    ‘’A minister of state is excusable for the harm he does when the helm of government has forced his hand in a storm; but in the calm he is guilty of all the good he does not do.’’

    Happy New Year for a new decade to all .

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  • Simon Stevens announced in 2014/15 that small Practices would be "allowed to wither on the vine".

    So yes, all according to plan. And if - with falling GP FTE and GPs' time increasingly diverted to PCN meetings, committees and contracts - PCNs are deemed by NHSE to have 'failed', we will become salaried to "other providers".

    As an independent medical body, GPs are a hindrance to the Global Health industry. This is their agenda.

    We must fight for survival of NHS general practice, or we'll be goaded into obsolescence.

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  • GPs will go the way of Bespoke Tailors. The public will get a lesser product from Primark.
    The Added Value and Altruism is too intangible to the calculating.

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  • No disrespect to Nick M but I think that paraphrased comment may more accurately be ascribed to Dr Twomey in NHS E, followed by rapid backtrack from NHS E saying its wasn't "policy."

    Our practice will soon regrettably join them, and I'm looking at another career/ early retirement has heartily f****d off with the NHS.

    Downside is I'll have to be treated by the "numpties"

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  • The war against small practices has been an act of unparalleled barbarity in the history of primary care. Led by Ideologues promoted beyond their capacity.

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  • No doubt CQC has something to do with it. If only they were more flexible in the way they assess.

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