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‘Every practice should close its list’ amid workload pressures, says BMA GP lead


‘Realistically, Every Practice Should Close Its List’ Amid Workload Pressures, Says BMA


Every GP practice should ‘realistically’ close its list due to the workload pressures general practice is facing, BMA GP Committee England deputy chair Dr Kieran Sharrock has said.

It comes as the BMA and former health secretary Jeremy Hunt have today joined forces to launch a new campaign titled ‘Rebuild General Practice’.

Speaking at an emergency press conference for the campaign, Dr Sharrock said: ‘There are places where practices have a short-term problem and they close their lists for a short period of time. 

‘But realistically, every practice should close its list, because we can’t take the workload.’

Speaking to Pulse following the conference, Dr Sharrock clarified that practices ‘could’ close their list, as it is an ‘option’ they have.

But he said they must also ‘think about the patients’, as ‘if they are in area where there aren’t any other surgeries, what happens to those patients who can’t get a doctor’.

‘Theoretically, every practice could apply to close their list. Then the Government would have to work out where to commission that service from.’

As it stands, the current patient workload for GPs is not ‘safe’, according to Dr Sharrock.

While the BMA recommends GPs see no more than 25 patients a day, Dr Sharrock told the conference: ‘Regularly, I do over 90. Is that safe? Would you want to be patient 91? Probably not.’

And he told Pulse that if practices are doing ’50-100% more patient contacts in a day than they really should be’, then ‘the argument follows that if that is not safe, to remain safe you should close your list’.

As a result of the demands on GPs, Dr Sharrock warned of more practice closures in the near future.

In his keynote speech, Dr Sharrock said: ‘To put it bluntly, your practice may soon no longer exist. At the current trajectory, your local surgery will have to close.’

He added: ‘In the last eight years, over 800 practices have closed. Two and a half million patients have lost access to their personal doctor.

‘I have seen what happens when there aren’t enough doctors, the system turns away those who cannot afford healthcare. That is, unfortunately, where we are heading.’

To combat practice closures, he said: ‘We need the biggest recruitment drive in the history of general practice.’

But he complained that the Conservative party has ‘no plan to support the workforce who shouldered the true burden’ of extra appointments during the pandemic and Covid vaccinations. 

The Department of Health and Social Care (DHSC) told Pulse last month that NHS England would set out a workforce strategy ‘in due course’.

However, health secretary Sajid Javid has said there would be no additional funding for workforce expansion as part of the work to clear the NHS backlog.

And York GP Dr Brian McGregor questioned whether the crisis in general practice is an access problem or a capacity problem.

He said: ‘Providing the workforce and planning for the workforce is actually the job of NHS England and the [health secretary], it’s not your GP’s problem. And if your GP is already working more than they’ve ever worked before, how do you ask more of them?’

When asked what role politics can play, former health secretary Jeremy Hunt said: ‘We have to be honest with people about the problem. And we have to be honest that there isn’t an overnight solution, and put the long term solution in play.’

In terms of which areas will be hit the hardest by practice closures, Dr Sharrock said it is likely to be in deprived and rural areas, ‘because they’re the places [where] we’ve traditionally found it more difficult to recruit’.

He said: ‘So if you already find it difficult to recruit, it’s therefore more likely that if someone leaves, you’re going to have difficulty maintaining a safe service.’

Dr Sharrock proposed measures to address workforce issues including:

  • Removing the cap on medical school places;
  • Lifting the limits on the number of international trainees so that the UK can attract young doctors from around the world to work in general practice; and
  • Using the Chancellor’s spring statement later this week to expand medical school places, investing in GP premises and infrastructure and supporting NHS staff.

READERS' COMMENTS [2]

Patrufini Duffy 22 March, 2022 2:04 pm

Dentists are open now, apparently.

Long Gone 22 March, 2022 9:21 pm

We all know why and how this happened – a malignant alignment of CQC, GMC, A&R, NHS-E, media vilification, pensions, workload and complaints escalation.
To reverse and remediate these in sufficient time would need an almighty power with the ability to pull multiple levers very hard, simultaneously and very quickly. This is not going to happen.
Nothing will change, GPs will be (in the words of the report) “agglomerated” into “scale operations” (most likely hospital-based), the quality of service will be pretty poor and impersonal as a result and the politicians will blame us.
I’ve been watching this for over 30 years – thankfully now from the sidelines. The trajectory is clear. The solution is equally clear: find a way out, to exercise your skills on better terms for more realistic reward and with less hassle. ASAP.