By Gareth Iacobucci
GPs have accused their PCTs of harassing them in a bid to drive them out of their surgeries, as a crackdown on smaller and single-handed practices gathers pace.
Pulse recently revealed that more than one in six English trusts are planning a cull of GP practices as part of a £20bn cost cutting drive, potentially sounding the death knell for singlehanded practices.
A number of GPs who have contacted Pulse say they are now being pressured by over-zealous PCTs, with managers looking for excuses to close them down. But NHS managers have denied they are pursuing a policy to close down small practices.
One single-handed GP in Greenwich, South East London, who wished not to be named, said she feared she was being targeted for closure, as the trust scrutinised her contract using traffic-light style ratings.
She said NHS Greenwich was zoning in on her practice's QOF scores, and using the availability of services such as immunisation and cervical cytology to inspect her performance.
She said: ‘I know it needs to be done, but I am being harassed. If they want to close single-handed practices, they should come out and say it. But PCTs are pushing doctors to retire by trying to highlight their weaknesses. Nobody is telling the good points of single-handed practices.'
A single-handed GP in Hounslow, West London, who also wished to remain anonymous, said NHS Hounslow was using the state of her premises as an excuse to try and close down her surgery.
She told Pulse: ‘I applied for funding for an upgrade five years ago which was accepted. It has never arrived, and now they are saying the building isn't suitable. The next thing you know, they want to close me. The PCT is the mother of all bullies.'
A spokesman for NHS Hounslow said: ‘There is not a policy to target single-handed practices, though we do encourage greater collaboration between practices and will help those who choose to merge.'
‘NHS Hounslow, as have all other PCTs, has carried out a GP premises condition survey. Following this survey NHS Hounslow is investing in premises improvements, with the exception of one practice where we are working with the practice to find an alternative solution.'
A spokesperson for NHS Greenwich said: 'We have been undertaking a review of PMS and GMS contracts, and are rigorous about the way we apply performance standards evenly to all practices.
'Our contracts with GP are monitored closely, but this is to ensure that the quality of care which patients receive is of a high standard.
Dr Peter Swinyard, chair of the Family Doctor Association, and a GP in Swindon, said some PCTs had become ‘very aggressive' towards single-handed GPs.
He said: ‘One or two have become very aggressive in their dealings with single-handed practices, and have a blinkered-view that large is beautiful. A lot of it is down to premises problems, they are the ones that PCTs have their sights on.'
Dr Swinyard said some trusts were using premises as an excuse to turf GPs out, with inner city areas such as London, Birmingham and Manchester all under scrutiny.
‘Some choose performance management, some choose the weasly way out, and use premises as an excuse,' he said.Closed sign (credit: James Cridland) More on...