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A faulty production line

Practice closures displace 1.3m patients in five years

Exclusive Over a million patients have had to move surgeries in the last five years due to practice closures.

According to figures obtained by Pulse, 1.3m patients have seen their surgery closed or merged as a result since 2013.

GP leaders said the figures ‘will resonate with the experience of GPs across the country’ and show ‘a serious failure of the system’.

However, NHS England maintains that vulnerable GP practices have received millions in funding to prevent practice closures.

The figures, which were obtained through freedom of information requests, show that in 2017 alone at least 283,000 patients had to find a new GP after 129 practices either closed or merged.

This is compared with figures from 2013, when just 18 practices shut their doors, impacting at least 23,000 patients.

Furthermore, the most recent data could be an underestimate as – due to NHS England’s delegating commissioning of GP services – they are based on responses from CCGs, and some were unable to respond to the request.

BMA GP Committee chair Dr Richard Vautrey said: ‘These new figures will resonate with the experience of GPs across the country as the recruitment and retention crisis in general practice is impacting practices of all sizes and all situations, as doctors face the pressures of rising workload, increasing administrative burden and a lack of resources.

‘Practices in rural and coastal regions, where the distance from large cities becomes a major obstacle in drawing in new recruits, have been particularly badly hit.’

He added that national initiatives to recruit GPs into these areas ‘will take some time before producing results’.

This comes after the Government admitted that GPs are leaving deprived areas of England at a faster rate than wealthy areas, despite financial incentives to attract trainees.

RCGP chair Professor Helen Stokes-Lampard said: ‘Sometimes, a closure is due to a practice merging, or becoming part of a federation, so that it can pool resources in the best interests of patient care.

But when it is because the practice team simply can’t cope with the resource and workforce pressures they are facing, it’s a serious failure of the system.’

She added that GPs handing back their contracts ‘is becoming increasingly common up and down the country, but particularly in rural and other ‘under-doctored’ areas where practices are finding it more difficult to recruit new GPs.’

Pulse has spoken to GPs in many of these areas, including Folkestone where GPs have said there is one GP for every 2,500 patients and Bridlington where withdrawn premises funding could be a 'death knell' for general practice in the area.

An NHS England spokesperson said: ‘More than 3,000 GP practices have received extra support thanks to a £27 million investment over the past two years and there are plans to help hundreds more this year.

‘NHS England is beginning to reverse historic underinvestment with an extra £2.4 billion going into general practice each year by 2021, a 14% rise in real-terms.’

NHS England told Pulse earlier this month that £16m of the £40m GP resilience fund has been spent on 2,100 practices, in addition to £10m through the vulnerable practice fund. 

The number of practice closures and the effect on patients

 YearTotal surgery closuresTotal patients displacedExtrapolated total number of patients displaced

























Source: Pulse FOIs to NHS England and CCGs asking how many surgeries had been closed as a result of practice closures, surgeries closing as a result of mergers, and practices closing branch surgeries. It also asked how many patients had to move surgery as a result.

The extrapolated figure takes into account the number of surgeries that had closed where commissioners were unable to provide us with patient list sizes multiplied by the average list size for surgeries that closed that year.

The total practice closures for 2013-2016 are comprehensive. However, the 2017 total may be short, as – due to NHS England delegating commissioning of GP services - they are based on CCG responses, and some were unable to respond to the request.

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