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Almost 100 GP practices closed last year



Exclusive Almost 100 GP practices closed in the UK in 2019, new figures collected by Pulse show as GPs warn Covid-19 could prompt even more to shut this year.

The 99 closures last year, which included whole practices, branch practices and closures as a result of mergers, meant nearly an estimated 350,000 patients were forced to move to a new surgery.

It continues an ongoing yearly trend of large numbers of GP surgeries shutting – up from just 18 in 2013 when Pulse first started tracking the issue.

The 2019 data, collected from responses to freedom of information (FOI) requests sent by Pulse to all CCGs and health boards across the UK, show there were fewer closures than the 138 seen in 2018 (see charts, below).

GP leaders said contract changes in England in 2019, which saw extra funding channelled through primary care networks, may have helped stem some closures last year as it provided some financial stability.

But they warned they expect to see far more practices shutting 2020 due to the Covid-19 response, which ‘poses new threats to viability’.

The latest workforce figures from NHS Digital show the number of full-time-equivalent GPs in England is continuing to fall – dropping by 651, from 28,256 to 27,605, between June 2019 and June 2020.

Wessex LMCs chief executive Dr Nigel Watson said an increase in funding to hire more clinical staff and the formation of primary care networks as part of the 2019/20 GP contract in England had only temporarily reassured some practices about their future.

He said: ‘The additional roles funding has been a catalyst to get practices to work together, and in some cases PCN practices realise that if one falls over it will have a negative impact on all the others – so some mutual support has happened.’

But he warned: ‘I think it’s quite possible we will see more [closures] unless we continue to support general practice.’

Londonwide LMCs said it had seen high levels of GPs nearing retirement and large numbers of vacancies in the capital over the past four years. Pulse’s data show the capital suffered 18 closures in 2019, affecting an estimated 61,000 patients.

Dr Michelle Drage, chief executive of Londonwide LMCs, said: ‘Throughout this time we have consistently found that a third of practices are carrying GP vacancies and two-fifths have impending retirements – the workforce crisis that threatens the stability of so many London practices is not going away.

‘The coronavirus response poses new threats to viability, with infection-control measures and increased demand further stretching resources, and lack of full reimbursement of pandemic-related expenses squeezing finances.’

BMA GP Committee workforce lead Dr Krishna Kasaraneni added: ‘There are added challenges of the Covid-19 pandemic, which we could expect to be reflected in the practice closures figures for 2020. Through this, practices have worked tirelessly to maintain services for their communities.

‘With a possible second Covid spike and the onset of a major flu vaccination programme imminent, practices are looking for guarantees that additional resources from NHS England will be forthcoming.’

NHS England said the creation of PCNs had helped slow the number of practices shutting last year, while health departments in Scotland, Wales and Northern Ireland highlighted efforts to increase GP numbers and improve support for practices.

An NHS England spokesperson said: ‘While this represents a very small proportion of practices, in some cases surgeries have merged with a nearby practice and in other cases a partner may have retired.

‘The expansion of primary care networks is ensuring greater availability of the right kind of appointment for patients – whether face to face or remote – and support for constituent practices.’

A Scottish Government spokesperson said: ‘We now have a record number of GPs working in Scotland with more per 100,000 population in Scotland than rest of UK. We are also committed to increasing the number by a further 800 over the next decade and to investing £250 million in direct support of general practice by the end of the current parliamentary period.’

They added: ‘The trend over a number of years has been towards fewer, larger practices but this does not mean a reduction in service. Patient safety is always the priority when a change to practice provision is proposed.’

A Welsh Government spokesperson said: ‘As is the trend across the UK, we expect to see a shift towards larger GP practices, with a wider skill mix of healthcare professionals in one setting, providing a greater range of healthcare services locally.

‘Since the launch of our “Train Work Live” campaign, we have significantly increased the number of GP trainees – the number of new GPs training in Wales has increased by 13.5% since last year and by 58% since 2018.’

A Northern Ireland Department of Health spokesperson said: ‘In 2019 two GP practices were taken over by other local practices and one practice closed with the patients being assigned to a number of practices in the local area.

‘Three practice mergers also took place, ensuring longer term sustainability and offering patients an increased range of services through access to a multi- professional workforce, including new roles such as practice based pharmacists and advanced nurse practitioners.’

A recent FOI investigation by Pulse found CCGs have been sitting on millions of pounds of unused additional roles funding after PCNs struggled to recruit in 2019/20.

Meanwhile a separate FOI investigation by Pulse found GPs in England had so far been reimbursed an average of less the £2 per patient for Covid-related costs.

READERS' COMMENTS [16]

Turn out The lights 7 October, 2020 9:26 am

Combine this with the loss of 600 GPs a year and the country needs to be very very scared of a soon to be unsustainable NHS .Hope they all have deep pockets.

David jenkins 7 October, 2020 10:50 am

they were warned about the retirement bulge years ago – in plenty of time to deal with it.

they ignored us – even exaccerbating it by introducing more silly rules and interfering with our pensions.

now they are electing to make our lives even more miserable in the current covid crisis by penny pinching, insulting us, and generally trying to belittle and bully us.

this won’t go away – keep making our lives a misery and things will spiral, and the domino effect will ensure more gp’s will leave.

come to locumland, where you have a lot more control, and life is good.

thank god i got out in 2007.

Mohammad Afzal 7 October, 2020 11:06 am

I have colleagues who are struggling for work. This situation is completely strange, some GP’s cannot find locum or decent salaried work.

Chris Cole 7 October, 2020 11:19 am

Can someone explain how the mass employment of social prescribers has helped stem closures or reassured anyone??

David Melville 7 October, 2020 12:05 pm

Not surprising. Practices finances are on a knife edge. Partnership no longer has the rewards to make the risks worth taking. Since my retirement from partnership I have not been replaced. Practice now has approximately 4000 patients per whole time equivalent, when I started in the early 1990s it was around 1800-2000. At current locum prices there is not enough money within a partnership to cover all the vacancies, so partners work ever longer hours. In the year before retirement I was working 12-14 hour days 5-6 days a week. Not sustainable long term .

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The Prime Minister 7 October, 2020 2:07 pm

The tories seem to believe that all GPs are lazy, cunning, stupid and greedy……the questions sare therefore if being a GP is so well paid and amazing, why are hospital doctors not all re-training to become GPs?????
The other big question is if the Tories really want more people to see GPs, then why are they portraying GPs as lazy and stupid and incompetent…who wants to see a lazy, stupid, incompetent doctor??????

Patrufini Duffy 7 October, 2020 2:56 pm

The NHS is perhaps the most diseased entity in British healthcare. Unspoken truths, fear to whistle blow, degradation of joy and wellbeing in a workplace and endemic professional bullying by NHSE and British media. It is a perverse set-up to make you fail, and insurance companies and HCA (HEALTHCARE AMERICA) are eagerly waiting for their ripe bonanza.

The Prime Minister 7 October, 2020 4:05 pm

Sure thing pal.

Shucks, Damn lucky that our friend in the UK (The Daily Nutter) has been softening up those pesky GPs so as we can mop up and take over from those limeys.

Just got to shake off this Covid thing first……….

Vinci Ho 7 October, 2020 4:52 pm

‘’NHS England said the creation of PCNs had helped slow the number of practices shutting last year, ‘’
Really , seriously ??
Can somebody give some evidence to this poor and f***ing ignorant PCN clinical director called Me?

Turn out The lights 7 October, 2020 5:18 pm

The creation of PCNs is a major destabiliser for GP land,combine that with homeopathic funding and no one in the cupboard to fill the under funded I’ll thought out paramedical roles the roll out of 8 till 8 7 days a week will destroy the service.But hey ho the push I will need to jump ship.

Robert Bruce-Chwatt 7 October, 2020 9:09 pm

I’m so glad I left 5 years ago.

Julian Mead 8 October, 2020 1:02 am

Test