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DH urges BMA to ‘consider detrimental impact’ of mass GP list closures

The Department of Health has urged the BMA to consider how patients would fare if it were to put its threat of collective practice list closures into action.

The DH acknowledged that GPs ‘are under more pressure than ever’ but suggested last year’s GP Forward View rescue deal was resolving the problem.

GP leaders told Pulse they will use their survey, revealing over half of practices are willing to close lists to new patients due to workload, to push the Government to make good on promises from the deal.

Although not a formal ballot for industrial action, the poll revealed 54% of GP practices would consider temporarily suspending registrations to ‘focus on delivering safe care to patients already on their practice list’.

A DH spokesperson said: ‘GPs are under more pressure than ever, so we are backing the profession with an extra £2.4bn of funding for general practice by 2020.

‘We speak regularly to the BMA about issues concerning general practice and would urge them to consider the detrimental impact which list closures could have on patient care.’

But BMA GP Committee chair Dr Richard Vautrey said the survey result showed that ‘the GP Forward View promises have not delivered sufficiently so that practices, or individual GPs, can see a tangible difference to their everyday working arrangements and the workload pressures that they are under’.

He said: ‘I think the reality is that practices are putting their patients first. They are seeing the pressures that their practices are under and their first priority is their existing patients, the patients they see on a day-to-day, week-by-week basis.

‘They need to provide safe care for them and this would be a step that would be part of delivering that safe care to their patients.’

He went on to outline four key areas in which the Government has to make urgent progress in order to stop practices from taking desperate measures like collectively closing lists, namely GP workforce; indemnity costs; practice workload; and premises development.

He said: ‘I think we do need to see a step change around workforce issues. We need a standard workforce, not a substitution of GPs. We need an expanding workforce as a whole.

‘We need a swift solution to the indemnity crisis because many GPs are very worried it will ultimately mean they are not able to work over winter because of the accumulative cost of indemnity.’

In addition, reflecting policy set at the BMA’s Annual Representatives Meeting in June, Dr Vautrey said GPs need ‘clear ability for practices to declare workload limits so that they can protect themselves and protect their patients’.

Finally he called for ‘resolution to premises issues’, highlighting the broken Government promise of a £1bn injection in upgrades.

He said: ‘We have still not seen delivery on the promise of funding to support premise development, whether that be repair, or expansion of premises so that practices can work in a way that they need to for their patients.

‘I think it’s those areas, that the Government can deliver on, where we need to see some change.’

The news comes as the new line-up of the GPC England negotiating team are in the process of updating last year’s Urgent Prescription for General Practice, and Dr Vautrey said these demands would be the priority areas in that document.

The document will also push for CCGs to devolve funding from medicines optimisation budgets to GP practices to ensure they can hire longer-term workforce such as practice pharmacists, Dr Vautrey added.

He said: ‘Rather than having funding that’s short term and evaporates into nothing, what we need is recurrent funding so we can have a sustainable expansion of the workforce, and some of that funding is currently within CCGs.’

Asked whether these moot points would take precedent when the GPC starts annual contract negotiations, due to begin ‘within days’, Dr Vautrey said: ‘I think we need to see what the initial response from Government is but I think ultimately this is a crisis that is self-evident and that is now being made clear by practices.

‘We do need a long-term solution that gives everybody confidence that the future will be one in which GPs and practices can play a part in sustaining the NHS and delivering good services to their patients.



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