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Hundreds of ‘desperate’ practices apply to close lists, but one in three is declined



Exclusive  Around 100 practices a year are taking the ‘last resort’ of applying to close their lists, but almost one in three is turned down.

Figures, obtained through a Pulse request to NHS England under the Freedom of Information Act, reveal there were 100 applications in 2014/15 and 99 the year before, more than double the 48 in 2012.

In the 20 areas that were able to provide full figures, 56 of the 188 applications – 30% – were turned down.

GP leaders said NHS managers should ‘respond positively’ to requests to close lists as they signalled practices were in distress, but NHS England told Pulse it turns down requests because of the impact on neighbouring practices.

Family Doctor Association chair Dr Peter Swinyard said asking to close a list is not something practices do lightly, but as a ‘last resort’ when they can no longer safely take new patients.

He said: ‘If you’re desperate enough to say “we have to close our list just to survive” and NHS England says “no”, I can imagine some partners will feel they are not getting any support and will feel compelled to hand in their resignations.’

GPC deputy chair Dr Richard Vautrey said such an application was a ‘red flag’.

He said: ‘It’s essential NHS England and CCGs respond positively to requests to close lists as these can be red-flag warnings of serious pressures in the practice that have become unsustainable.’

NHS England said: ‘When we receive a request to close a list, we consider the impact on patients as well as on neighbouring practices and services. We know GP practices are under pressure and we don’t wish to see a problem displaced elsewhere.’

Earlier this year, Pulse blogger Dr Hadrian Moss was threatened with a breach-of-contract notice after taking steps to close his practice’s list informally in line with GPC advice.

However, after Dr Moss persevered, NHS England told LMCs practices with short-term staffing problems could ‘temporarily’ stop taking new patients on an informal basis.

But it is not clear from the NHS England figures how many practices may have chosen to take this option.

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