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10% of GP practices ‘to close due to cash crisis’

By Gareth Iacobucci

Exclusive: Government forecasts predict one in ten GP practices will face closure in the next three years due to the squeeze in NHS finances.

The shattering forecast was disclosed during a meeting between LMC leaders, PCT bosses and a senior civil servant, who revealed that the efficiency drive made more acute by the financial crisis had led the previous Government to predict a dramatic reduction in the number of practices.

It comes as a Department of Health document, uncovered by Pulse, reveals instructions to NHS managers to ‘remove very poorly performing practitioners' in order to tackle the wide variation in GPs' performance.

Although the pronouncements were made prior to the change of Government, experts predict the coalition is set to continue the direction of travel by removing practice boundaries and making it mandatory for GP practices to join federations under the new GP commissioning regime.

Dr Simon Bradley, chairman of Avon LMC, said a meeting with a top official left him in no doubt about the bleak future facing some practices.

In a newsletter to local LMC members, he wrote: ‘I attended a meeting recently where a very senior civil servant gave the GP and PCT leaders the message that one in ten practices would go to the wall in the next three years, due to the current crisis in national finances.'

‘Who would be vulnerable? Low earning and financially inefficient practices, certainly, and those that don't meet the criteria on the PCT's unbalanced score card.

He added: ‘Rural and commuter belt practices will be particularly vulnerable as practice areas are done away with and healthy, low demand patients register near their workplace.

‘For each one in ten that fails, there must be three or four in ten who struggle to survive as income falls and work increases and morale plummets.'

The forecast is given credence by a document produced by the Department of Health's Health Inequalities National Support Team, obtained by Pulse, which urges NHS managers to take tough measures to reduce variation in GP performance by ‘removing a handful of very poorly performing practitioners who are not able to improve'.

It says: 'It is important to strongly challenge practices causing concern to ensure they are under pressure to improve, and feel themselves under ongoing scrutiny.'

Dr Bradley told Pulse that although the goalposts had moved under the new Government, he expected the direction of travel to continue, and said the decision to press ahead with the abolition of practice boundaries would continue to threaten the viability of some practices.

He said: ‘Practices will need to work in a much more co-ordinated way to try and ensure that we're able to improve quality. I don't think we're protected from the financial squeeze, and I'm still very worried about the consequences of boundary changes.'

Dr Simon Bradley