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GP recruitment crisis forces removal of thousands of patients from practice list

Exclusive A practice is having to deregister 1,500 patients from its list because recruitment problems have meant partners’ workload is above ‘clinically safe’ levels, Pulse has learnt.

Watton Medical Practice in Norfolk has had to write to patients asking them to find a new practice after efforts to replace two GPs failed, leaving it with a ratio of 2,700 patients per GP – which its practice manager said is compromising the standard of patient care.

Local leaders warned that this could cause a ‘domino effect’, which could put neighbouring practices under greater pressure.

GP leaders said practices are requiring ‘desperate solutions’ to the recruitment crisis.

The move by Watton Medical Practice, which has a list size of 13,500 patients, follows a series of drastic actions taken by practices to mitigate the effects of the recruitment crisis, including offering £20,000 ‘golden hellos’ to prospective partners, and building practices around teams of nurse practitioners.

Mary Osborne, practice manager at Watton Medical Practice, said it was ‘an immensely difficult decision’ to make but that because recruitment efforts have failed, the list review is ‘the only option’ left to ensure services are safe for patients.

She said: ‘Due to circumstances beyond our control and the continued growth in population within the Watton area we have had to review our patient list. Patient safety is paramount in the services we provide and the ratio of patients to doctors has increased above that which is seen as clinically safe within the NHS, and, we feel, is compromising the standard of care that our patients need and expect from us.’

Norfolk and Waveney LMC medical secretary Dr Ian Hume said the practice had been unsuccessful in using innovative working, such as doctors providing a triage service and building around nurse practitioners, and said they were left with few options.

However, he warned neighbouring practices could face greater pressure. He said: ‘Asking significant numbers of patients to re-register obviously puts greater pressure on neighbouring practices who are also struggling and also having problems. So it is a destabilizing domino effect.’

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NHS England’s local area team said it had been working with the practice together with the LMC, South Norfolk CCG and NHS England for help to solve the recruitment problem.

A spokesperson said: ‘Watton Medical Practice knows that patients affected will be upset at having to register with an alternative GP practice and is very sorry for any disruption this may cause.’

‘Difficulties in the recruitment of GPs is a national issue as well as being particularly evident both in Watton and in Norfolk more widely. The practice has been unable to recruit enough GPs to ensure it can continue to provide the standard of care which patients need and expect.’

It added that the list closure remained a temporary measure.

GPC deputy chair Dr Richard Vautrey said the Government has to do more to sort out the crisis in the long term, while area teams should do more in the short term, such as fundingpractices to offer ‘golden hello’ payments.

He said: ‘Practices are in a desperate situation and are looking to desperate solutions to try and solve that.’

‘The long-term solution is actually getting doctors into the practice, and into other practices in similar situations, who are there for the long term… You might at using “golden hello” type of scenarios for providing support practice [or] putting in place innovative ideas about refunding student debts for some young doctors to work long term in certain areas.’

‘There are various solutions that could be put forward [but NHS England] area teams have not yet shown the willingness or commitment to try and do that.’

It comes as Pulse reported of a Doncaster practice where GPs were forced to dig into their own pockets to fund a £20,000 ‘golden hello’ payment.

Meanwhile, Health Education England has stepped in to help fund recruitment efforts in Essex, where practices have been severely suffering from problems with recruitment.

Pulse reported earlier this year that a GPC paper said ‘the time has come to declare that the workforce gaps in general practice have reached crisis point,’ the consequences of which could be ‘catastrophic’.