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All seven practices in town set to close patient lists en masse

Practices in another town have applied to completely close their lists, saying they are ‘unable to take on more patients safely’.

The seven practices in Folkestone – which cover around 64,000 patients - have applied to NHS South Kent Coast CCG for formal list closure, saying there is a shortage of 16 full-time equivalent GPs.

They took the step of applying for formal list closure after they announced this month that 4,700 patients previously under the Folkestone East Family Practice (FEFP) would be - in the practices’ words - ‘forcibly allocated’ to practices after partners handed back their contract in May.

This is the latest in a growing number of towns that have had to close their lists en masse, including Bridlington in East Riding of Yorkshire and the Three Towns area in Ayrshire, Scotland.

This move also comes after a survey of GP practices by the BMA revealed half of practices were willing to close their lists in response to the pressures facing general practice.

The BMA said that what was happening in Folkestone was indicative of pressures across the country.

A statement issued by the practices in Folkestone said: ‘The following GP surgeries - Central Surgery, Guildhall St Surgery, Hawking & Elham Surgery, Manor Clinic, The New Surgery, Park Farm Surgery, Sandgate Rd Surgery - have taken the unprecedented action of applying to NHS South Kent Coast CCG for formal list closure in order to maintain safe patient care to their current patient population.

‘We all feel that as a consequence of the national GP shortage which has been acutely felt in Folkestone, with a shortage of 16 full time equivalent GPs we have no other option in the interest of patient safety.’

The practices say they have been highlighting the crisis for ‘over a year’ to local authorities, including the CCG, the council, the local foundation trust and the local MP.

The statement added: ‘The crisis became more acute with the handing back of the Folkestone East Family Practice (FEFP) contract which affected 4,700 people in May.

‘The practices have advised the CCG throughout that we are unable to take on more patients safely without long term investment in clinical staff as well as infrastructure to ensure the safe integration of these patients without jeopardising patient care for all residents of Folkestone.’

Dr Richard Vautrey, chair of the BMA’s GP Committee, said: ’This crisis in Folkestone highlights why four out of ten GP practices in England told the BMA in a survey only last week that they were considering applying to have their practice lists closed because their services are at breaking point. Many GP services across the country are being put under unsustainable pressure from rising patient demand, falling funding and staff shortages that are stopping them from providing safe, effective care, including enough appointments, to their local communities. The situation for practices is made even worse when one in the local area closes altogether and local health bodies fail to provide sufficient support for those practices remaining.

’It is unacceptable that even one surgery should be being placed in the position of having to close their practice list. We need politicians to realise that general practice needs an urgent, immediate plan to invest more resources into frontline patient services as we cannot allow GP services to slide further into crisis.’

A spokesperson for NHS South East Kent CCG said: ’If a GP practice feels it needs to close its patient list over a significant period, it must apply to us so we can consider the potential impact on patients and neighbouring practices and avoid displacing a problem elsewhere.

’We have received applications from seven practices in Folkestone to close their lists to new patients. These applications will be considered by the CCG and we will reply to the practices within 21 days.’

They added: ’To support practices to take on new patients, the CCG will pay practices an additional £42.68 per patient to support any additional costs for the first year. This compares favourably with other patient distribution investments to recognise the specific issues in Folkestone.’

Please note - this story was updated at 13:15 on 14 September 2017. The CCG originally said it would pay an additional £48 per patient, but it later corrected this to £42.68p.

Pic credit: John Fielding

Readers' comments (15)

  • If the practices can't cope, they can't cope. How does offering an extra 48 pounds per patient help them to not cope?

    If there are no doctors to fill the 16 full-time shortage, there are no doctors.

    What is it the CCG's don't understand?

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  • £48 is less than half the cost of a visit to A+E yet GP's expected to accept unlimited extra workload for the first year?
    When will NHSE properly commission primary care?

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  • Just Your Average Joe

    Great £48 per patient year one extra - drown year 2 once additional support funding runs out.

    Its OK as manager at NHS England promoted out for resolving GP impasse the previous year, and works elsewhere now!

    Who cares if list closed?

    NHS England managers will just allocate the 4700 patients - accross the practices and you can't refuse them. So what's the point of a closed list.

    If the list is truly closed then NHS England has to find and fund alternatives GP care provision for the 4700 patients at high cost and risk to them of poor publicity especially if any harm comes to those without routine care.

    Now that scenario of NO care for 4700 patients would get headlines.

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  • Formal Application to the CCG for a planned list closure is one options; immediate unilateral closure on grounds of 'full to safe capacity' is another (GMS contract specified, the local LMC is very familiar with it). This is a town with a GP hub (PMCF 8-8 initiative)... so patients'll still get care.

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  • Captain Blackadder strikes again "This is a crisis. A large crisis. In fact, it's a twelve-storey crisis with a magnificent entrance hall, carpeting throughout, 24-hour portage, and an enormous sign on the roof, saying 'This Is a Large Crisis'. A large crisis requires a large plan. Get me two pencils and a pair of underpants"..... Blackadder was right, I think we have all had to figure a way out of this mess for ourselves

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