Exclusive NHS England has rejected one in four requests by practices to shrink their patient catchment areas since April last year, despite ‘desperately overstretched’ GPs struggling to cope with rising patient demand, Pulse has found.
The number of requests, to reduce the number of patients eligible to join the practice and in some cases also to deregister existing patients, are rising with 26 of them made since April this year compared to 30 for the whole of 2013/14.
However the data, obtained by Pulse via a Freedom of Information Act request, showed that NHS England has rejected 15 of those requests already, with 10 decisions still pending and six requests withdrawn.
GP leaders argue that rising requests are inevitable with ‘desperately overstretched’ GPs seeking ways to cope with rising patient demand and recruitment issues.
They also add that the findings raise further questions over whether practices will sign up to the Government’s plans to dilute practice boundaries from next year.
Pulse revealed earlier this year that requests to close practice lists to new patients risen by 160% in three years. Meanwhile two in five GPs have said they will refuse to open up their practice boundaries when the Government’s flagship policy comes into effect, with many saying they do not have the capacity to take on more patients
Pulse contacted 27 area teams via NHS England and found they approved 15 requests last year and signed off on 10 since April, while several decisions to deny requests are being appealed by GP practices.
NHS England has said requests will only be approved if the area team decides that ‘there is still sufficient provision of other GP services for the patients affected.’
Family Doctor Association chair Dr Peter Swinyard said that no practice wanted to ‘regress and to shrink’, but it was a force majeure for practices.
He said: ‘This is people just basically saying: “We are not coping and we can’t cope with extra patients being forced on us”.
‘You have to take all patients who turn up at your front door who live within your practice boundary. They are just finding a way of restricting their workload when they are completely overstretched and struggling to find the medical staff to look after the patients. They are just trying to look after their patients to the best of their capacity, the number that they are actually capable to look after.’
Dr George Farrelly, a GP in Bow, east London, which shrunk its practice boundary area last year, said: ‘We basically all feel beleaguered. The amount of work we have exceeds our capacity, we can’t actually do the job properly, and if you then add more patients – and patient complexity – that eats into our capacity.’
GPC deputy chair Dr Richard Vautrey said the figures brought the Government’s policy to abolish practice boundaries into question.
He said ‘It is yet another sign of how practices are trying to cope with their rising workload demand. They are trying to ensure that they are providing a good level of service to their patients and one way to do that is to shrink their list. You can only deliver a safe service to a certain number of patients based on the resources that you have got.
‘Practices making this choice will undoubtedly have second thoughts about getting involved in the removal of practice boundaries. And there will also be practices which have not had to shrink its boundaries which will still choose to prioritise the patients who live close to them.’
Have practices in your area requested to shrink their boundaries? Check our table here.