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NHS England must be held accountable for every practice closure, says GPC chair

NHS England area teams must be mandated to ensure that none of its GP practices close, and must declare a significant untoward incident every time it does happen, the GPC chair has said in a passionate speech to the LMCs Conference today.

He also said that ’mass resignation is not just a threat, but an impending reality’, warning that GPs are already leaving the profession. 

Dr Nagpaul said that seven-day services were ‘immoral’, and praised NHS England for not focusing on weekend opening in its General Practice Forward View.

The LMCs Conference will debate tomorrow morning whether they will still push for GPs to submit undated resignations, as agreed by the Special LMCs Conference in January.

But Dr Nagpaul said that the numbers of GPs set to quit in the next five years means that it is no longer a threat, but a reality, regardless of tomorrow’s vote.

He said: ‘With government figures stating 38% of GPs intend to quit in the next 5 years, mass resignation is not a threat – it’s an impending reality. The Government must ensure we retain the current workforce, in particular tackling the perverse factors driving older GPs to leave early.’

Dr Nagpaul also focused on the issue of practice closures, referring to the £40m ‘resilience programme’ announced in the Forward View.

But he said that NHS England local area teams must be held accountable for practices closing.

He said: ‘It should be a significant untoward incident and a failing of the local NHS if any practice needlessly closes. This creates disruption and displacement of essential family doctor services to patients, and the domino effect of instability on neighbouring practices, not least wasted costs to the taxpayer of re-providing the service.

‘I therefore call upon NHS England to use the Forward View’s practice resilience programme to make it an explicit KPI for all Area Teams to ensure there’s not a single unnecessary or avoidable practice closure now or in the future.’

He pointed towards federations as a way of preventing practice closures, and said moves to collective working have helped practices stay afloat.

He said: ’Now is the time to resurrect that spirit of collectivism and mutual support. We need development funding for an in hours cooperative movement, and pull together in local communities as one GP profession.

’We’re seeing examples of this working already-in one instance a practice about to close after losing two partners was kept afloat by employed doctors in the local federation and is now back on its feet. In another example a federation’s urgent care hub was able to support a practice unable to cope due to GP illness.’

Dr Nagpaul highlighted NHS England’s plans for local commissioners to decide the level of routine capacity at evenings and weekends, and welcomed the flexibility that this offered.

But he added: ’It’s not gone far enough, but in the context of a manifesto pledge that formed the basis of the Government’s intransigence with our junior colleagues, we may have partly won the argument.

’Of course politicians will resurrect the seven day agenda but it’s vital that we hold NHS England to account to their words to ensure that the priority for seven days is where it should always be – for properly funded urgent care and GP out of hours services, and we must reject the immorality of taking GPs away from caring for acutely ill patients to sit in empty surgeries superfluous to need.’