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Fewer GP practices requesting list closure, official data reveal

Exclusive The number of GP practices closing their lists to new patients has started to taper off, a Pulse investigation has revealed.

A freedom of information request to NHS England showed 106 GP practices closed lists to new patients in 2017/18 – compared with 145 in 2016/17 and 175 in 2015/16.

The number of requests went down too.

The BMA’s GP Committee said the data could be an indication that schemes negotiated with NHS England to reduce pressure on GP practices have begun to have an effect.

In total, NHS England received 148 requests to close GP lists last year but it refused 42 of these request.

However, at 28%, this was a lower rate of refusal compared with 2016/17, when NHS England refused 37% of requests.

GP practice list closure requests to NHS England

Year 2016/17 2017/18
Total requests 231 148
Approved 145 106
Refused 86 42
Proportion approved 63% 72%

 

The official data tallies with a recent Pulse survey of GPs which shows fewer GPs intend to close their lists to new patients.

The survey of over 400 GPs found just 3.5% intended to apply for a temporary list closure in the next year, while a further 17% said they didn’t know.

This compared with 28% of Pulse survey respondents who said they were considering an application to close their list one year ago.

BMA GP Committee chair Dr Richard Vautrey suggested there could be a number of reasons behind the decline in appetite for list closures.

He said: ‘Some practices that were on the brink of closing have been supported by various initiatives, including the resilience scheme, whilst others are working closely with other practices across federations or networks which can offer mutual support.’

However he added that there was ‘still a lot that needs to be done to enable all practices to feel confident that they have the capacity and resources to cope with the significant pressures they continue to face’.

And survey respondents still reported difficulties resulting from NHS England declining requests.

A single-handed GP in the North of England, who did not want to be named, told Pulse he had applied twice to close his list but had been refused permission on both occasions. He said he was given no option but to ‘unofficially’ manage his list by creating a waiting register.

He said: ‘I went through the process, canvassed opinions from my colleagues. None objected, and I was refused with no reason given.

‘Considering I work with no nurse practitioner or salaried partner, a regular locum or GP registrar, my list of two thousand patients was relatively high per clinician compared to the neighbouring practices.

‘I have had no support from NHS England or my CCG. I believe the present inability to set a reasonable limit on your list size is unsafe and unhealthy.’

An NHS England spokesperson said: ‘Patients truly value their general practice services but they are under real pressure and we continue to invest and do all we can to support them in improving access and delivering excellent care.’

Are you planning to close your list in the next year?

Yes – 3.5%

No – 79.5%

Don’t know – 17%

The Pulse survey was launched on 12 April 2018, collating responses using the SurveyMonkey tool. The 28 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. 443 GPs responded to this question.