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34,000 patients left without a fixed GP as practices ‘sucked into black hole’



One-fifth of practices in Plymouth have either closed or handed back their contract in the past three years, leaving 34,000 patients without a fixed GP.

Local GP leaders said the city faces a ‘black hole’ with surrounding practices ‘getting sucked in’ as a report seen by Pulse from a meeting of local primary care leaders adds that 10 out of 52 practices in Plymouth and the surrounding area have ‘closed or handed back their contract’ in the past three years.

This comes after CCG leaders in Dudley told the Health Select Committee last week that practices in that area are closing at a rate of one every six months.

Dr Matt Best, vice-chair of the western sub-committee of Devon LMC, told GPs at the UK-wide LMCs conference last week that the contract-handbacks and closures in Plymouth mean 15% of patients ‘don’t have a fixed GP’.

However, NHS England has said that ‘only three small practices have closed since 2015’ with a total patient lists size of 6,650.

Access Health is managing care for the population on an interim basis – but at a cost 26% higher than the surrounding practices.

The social enterprise receives core funding of £190 per patient, compared with £151.37 for the average practice, according to figures supplied to Pulse by Access Health.

The report from a primary care meeting said the extra funding ‘is required to manage the fall out generated by a failed primary care service and we understand Access Health are not making a profit despite the extra funding’. 

But Dr Best said surrounding practices ‘are struggling to help look after those patients and typically the patients that are the well patients don’t end up reregistering’. 

He said: ‘It’s the complex difficult patients that re-register and add on to the lists of neighbouring practices and make it so difficult.’

Dr Best was speaking in favour of a motion at last week’s LMCs Conference expressing concern ‘about the number of recent practice closures’.

Dr Best added that the closures are ‘appalling and horrifying for the patients’, telling Pulse later that many are adding to the pressure on A&E ‘just because patients aren’t getting to see a GP’.

Pulse has previously reported that the 22,000-patient Ocean Health partnership in Plymouth was forced to close its patient list, after its partners handed back their contract because of rising patient demand and a shortage of GPs.

This comes after Paul Maubach, chief executive of NHS Dudley CCG, told the Health Select Committee that the number of practices in his area has fallen from 52 to 45 in five years.

However, he said including branch practice closures, this equates to one closure every six months.

He told the committee that general practice in the area ‘is not resilient’, adding that ‘there aren’t enough GPs coming through, but also the demand pressures on primary care are huge’.

Mr Maubach was speaking to the committee about the development of Dudley’s multispecialty community provider (MCP), which he said would shore up general practice in the area. 

The CCG launched the procurement process for the £5.4bn voluntary contract in June last year to create an MCP, with all GP practices and four NHS Trusts expected to sign the contract.

Mr Maubach later told Pulse that if hospitals were closing at the same rate as GP practices ‘everyone would be aghast and it’s surprising to me that there isn’t quite so much visible concern about primary care’.

He added that the GP Forward View ‘doesn’t go far enough’ and the MCP would allow general practice ‘not to stand in isolation but to be supported by the other community services which are out there’. 

The motion proposed at the LMCs Conference was passed unanimously.