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Pulse 2019 review: Practices closing in record numbers



Practice closures continued to hit the headlines in 2019, with 12 surgeries shutting up shop in January alone.

This compared with just eight during the first month of 2018, and added to the almost 140 in total that year. The stark reality was unveiled in a Pulse investigation in May, and showed just how bad things had got.

Pulse’s figures, gained through freedom of information requests, revealed that the 138 closures in 2018 had displaced more than half a million patients, many of whom had to be taken on by other, nearby practices, adding to their own strain.

There was little room left for doubt that measures aimed addressing diminishing practice numbers were doomed to failure. NHS England’s ‘resilience fund’ for vulnerable practices is one such example.

The numbers follow a worrying pattern. Between 2013 and 2017, 445 practices closed across the UK, affecting almost 1.5 million patients.

Patients are destined to suffer, especially in the hardest-hit areas of the country.

The impact of yet another practice closure in Brighton – the 13th in just four years – is that elderly and vulnerable patients might effectively be unable to get to see a doctor, thanks to the steep hill and distance they now face to get to their new surgery.

And the effect on neighbouring practices in places like Brighton is immense. Take Plymouth for instance, where adjoining surgeries to some that have closed are handing back their contracts, unable to cope with demand.

Nationwide, almost 90% of practices that closed in 2018 had lists of fewer than 5,000 patients, playing into the hands of those in power who are encouraging bigger practices.

This greater emphasis on large practice groups plays out in the form of primary care networks, each covering 30,000 to 50,000 patients, which were mandated in the 2019 GP contract.

We’ve heard tales of practices battling hard to buck the trend, yet their chances of success are bleak. One practice in west Wales faces closure after three years without a single GP, and providing only nurse sessions.

Countless others will see in the New Year unsure how long they have left before succumbing to the growing pressures.

If current trends continue, however, even more could be putting up their ‘Closed’ signs for the final time.