Exclusive A major Pulse investigation has revealed that 474 GP surgeries across the UK have closed in the past nine years without being replaced, with small practices on lower funding in more deprived areas most likely to be affected.
Pulse’s Lost Practices investigation – which will run throughout this week and next – examined for the first time the number of GP surgeries that have closed for good, the reasons behind the closures and the effect on the 1.5m patients that have been displaced.
It found that the final straw for the majority of practices that have closed for good have tended to be recruitment issues, although CQC ratings and the ending of APMS contracts were major factors too.
Previous investigations by Pulse and other groups have looked at the number of practices where GP partners have handed their contracts back, or closed branch surgeries, but this latest investigation is the first to focus only on those where a surgery has not been replaced, leaving patients to travel further to see a GP.
The investigation found:
- There were 474 surgeries that have closed in the UK since 2013, leaving 1.5m patients having to travel miles in some cases to new surgeries and placing other GP practices under even greater pressure;
- For more than 40% of the 162 surgeries we identified triggers for, recruitment issues were the final straw for the practice;
- These surgeries had markedly smaller list sizes than average – a median list size of 2,738, compared with a median list size of 7,904 in England in 2020-21;
- They were in postcodes that were in more deprived areas than other average surgeries – with a median deprivation score of 3.81 compared with 4.41 for an average practice (with 1 most deprived and 10 least deprived);
- 69% of practices that closed for good in England received lower funding per patient the last full financial year before they closed than the average funding for that financial year;
- A number of surgeries have closed with no other surgery within miles.
Pulse has found that smaller surgeries are far more likely to close. However, patient satisfaction scores have routinely found that patients prefer smaller practices and they are more able to provide continuity of care.
Practices in deprived areas are more likely to close. They have told Pulse their workload is higher, their patient population is less prone to self-care but they also miss out on funding that practices in more affluent areas receive.
Pulse has also produced a map plotting practices that have closed for good and currently active practices, which has showed pockets where there is no surgery because of a practice closure, which will be released later this week.
Professor Martin Marshall, chair of the Royal College of GPs, said: ‘The impact a practice closing on its patients and neighbouring practices can be considerable. As such, a decision to close a practice will be one of the most difficult a GP partner can make. There may be many reasons for a practice to close, in some instances it maybe that it is merging with another in order to pool resources, but when the reason for closing a practice is workload pressures, and not being able to fill vacancies, then this needs to be addressed as a matter of urgency.
‘General practice is the bedrock of the NHS with GPs and our teams making the vast majority of patient contacts and in turn alleviating pressures across the service, including in A&E. It works by providing cost-effective care close to home in patients’ communities. But it is a service that is struggling and it needs support. We don’t want to see patients having to travel for miles to be able to receive GP care.
‘This is why the College is calling on the Government for a new recruitment and retention strategy that goes beyond the 6,000 more GPs pledged in its manifesto, plus investment in our IT systems and steps to cut bureaucracy so that we can deliver safe, high-quality care for our patients.’
Pulse will be running findings from its investigation throughout the week on its dedicated section.
Additional reporting: Madeline Sherratt, Rhiannon Jenkins and David Burns
Please note, this piece originally said 474 practices had closed across England. But this should have read ‘across the UK’