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GP recruitment crisis forces removal of thousands of patients from practice list

Exclusive A practice is having to deregister 1,500 patients from its list because recruitment problems have meant partners’ workload is above ‘clinically safe’ levels, Pulse has learnt.

Watton Medical Practice in Norfolk has had to write to patients asking them to find a new practice after efforts to replace two GPs failed, leaving it with a ratio of 2,700 patients per GP – which its practice manager said is compromising the standard of patient care.

Local leaders warned that this could cause a ‘domino effect’, which could put neighbouring practices under greater pressure.

GP leaders said practices are requiring ‘desperate solutions’ to the recruitment crisis.

The move by Watton Medical Practice, which has a list size of 13,500 patients, follows a series of drastic actions taken by practices to mitigate the effects of the recruitment crisis, including offering £20,000 ‘golden hellos’ to prospective partners, and building practices around teams of nurse practitioners.

Mary Osborne, practice manager at Watton Medical Practice, said it was ‘an immensely difficult decision’ to make but that because recruitment efforts have failed, the list review is ‘the only option’ left to ensure services are safe for patients.

She said: ‘Due to circumstances beyond our control and the continued growth in population within the Watton area we have had to review our patient list. Patient safety is paramount in the services we provide and the ratio of patients to doctors has increased above that which is seen as clinically safe within the NHS, and, we feel, is compromising the standard of care that our patients need and expect from us.’

Norfolk and Waveney LMC medical secretary Dr Ian Hume said the practice had been unsuccessful in using innovative working, such as doctors providing a triage service and building around nurse practitioners, and said they were left with few options.

However, he warned neighbouring practices could face greater pressure. He said: ‘Asking significant numbers of patients to re-register obviously puts greater pressure on neighbouring practices who are also struggling and also having problems. So it is a destabilizing domino effect.’

NHS England’s local area team said it had been working with the practice together with the LMC, South Norfolk CCG and NHS England for help to solve the recruitment problem.

A spokesperson said: ‘Watton Medical Practice knows that patients affected will be upset at having to register with an alternative GP practice and is very sorry for any disruption this may cause.’

‘Difficulties in the recruitment of GPs is a national issue as well as being particularly evident both in Watton and in Norfolk more widely. The practice has been unable to recruit enough GPs to ensure it can continue to provide the standard of care which patients need and expect.’

It added that the list closure remained a temporary measure.

GPC deputy chair Dr Richard Vautrey said the Government has to do more to sort out the crisis in the long term, while area teams should do more in the short term, such as fundingpractices to offer ‘golden hello’ payments.

He said: ‘Practices are in a desperate situation and are looking to desperate solutions to try and solve that.’

‘The long-term solution is actually getting doctors into the practice, and into other practices in similar situations, who are there for the long term… You might at using “golden hello” type of scenarios for providing support practice [or] putting in place innovative ideas about refunding student debts for some young doctors to work long term in certain areas.’

‘There are various solutions that could be put forward [but NHS England] area teams have not yet shown the willingness or commitment to try and do that.’

It comes as Pulse reported of a Doncaster practice where GPs were forced to dig into their own pockets to fund a £20,000 ‘golden hello’ payment.

Meanwhile, Health Education England has stepped in to help fund recruitment efforts in Essex, where practices have been severely suffering from problems with recruitment.

Pulse reported earlier this year that a GPC paper said ‘the time has come to declare that the workforce gaps in general practice have reached crisis point,’ the consequences of which could be ‘catastrophic’.


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Readers' comments (31)

  • Una Coales

    It's not about the money. Most GPs are now women and we want to be able to juggle a family and work. Most do not want to be burdened with a 12-hour working day.

    For men, they want to have autonomy to practice and flourish, not be bogged down by rules and diktats.

    A golden handshake is not worth the cost to wellbeing.

    The NHS model is outdated. Time to encourage and help our young UK GPs achieve autonomy as semi private GPs with the freedom to set their own hours and pace.

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  • GPs get paid effectively £20-30 per hour after tax and other professional expenses, bugger off, I will spend time doing my own plumbing and gardening instead of using this time as GP in day time

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  • MP covering this area is a tory,hope he can sleep at night now it is happening on his patch.

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  • Vinci Ho

    (1) well respectful move because the practice has put safety of patients as priority . I am only curious how they chose the 1500 patients to deregister.
    (2) one will hope/wish these patients would understand the true predicament these colleagues are under. The truth of this story can be used by Patient Association or any 'pressure group' to pile more pressure on politicians. The Tory MP who complaint about Oxfam being politically driven in its recent campaign about poverty, has totally exposed the ugliest face of these politician.
    (3) Somebody said what is missing in British politics today is honour . We certainly know what it means in our profession while flying the flag..........

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  • Blimey Una.....bit sexist ! We kind of want an equal playfield these days

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  • Let's face it we have lost, it is over,in my 3 partner practice one partner is off long term sick the other is burnt out and wants to go to 4sessions, I can't get locums at any price I can't recruit a new partner as no one will take on the job and we are a rural dispensing practice,I am 56 and retire in 4 years and will close the practice and sell it for building land at twice the price the district valuation price, Hunt has won it is over

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  • Every Tsunami starts from ripples.... Gosh I feel like Vinci Ho posting sagely like this :D

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  • "GPs get paid effectively £20-30 per hour after tax and other professional expenses"

    Always amusing how GPs on here quote their hourly rate after tax.

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  • Dear healthcare professional @8;36 PM
    that's because what matters is what comes to pocket after all those long hours and responsibility. Because ultimately the buck stops with me when I take important decisions and everyone around me just passes it to me.
    If I don't feel its worth it I might work less and earn less ( do my own plumbing ,gardening etc )

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  • technically there is no crisis as primary is still functioning and in this case there is just a shift in service provider.

    we have to accept that with the challanges in funding there will be those practices that can innovate and survive and those that won't.

    it's a matter of rolling your sleeves up, getting stuck in, using innovation, restructuring and making best use of technology.

    in fact we are doing more with less resources thanks to the visionary intervention by ConDems.

    if there actually was a crisis u would expect the gpc, rcgp, bma to do something about it. since they haven't then there can be no crisis ...

    ... yes i am taking the mick

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