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Small practices must be saved from closure

Further to your article about practice closures, I would like to share with you my views and those of my GP colleagues.

(NHS efficiency cuts lead to raft of practice closures)

I agree with Dr Brian Balmer (who is also my LMC secretary) that there potentially could be a huge protest against the closure and phasing-out of small practitioners, both nationally and in south-east Essex. There has been a local comparison, as well as a survey done at Birmingham PCT, both finding small practices like mine perform better than larger ones – in spite of our inequitable funding system, which often sees them lose out.

I fail to understand how smaller practices are ill-equipped to handle the shift of work from the hospitals, as we already are doing a great deal of secondary care work in primary care, such as minor surgery, pre- and postoperative checks and other LESs.

Driving all practices into polyclinics is not going to make efficiency savings – indeed, there could be savings in avoiding duplication, or even triplication, of existing services through Darzi centres, NHS Direct and walk-in centres.

Darzi centres have failed to achieve their target of registering sufficient patients and instead all they are doing is providing walk-in services that are often not required.

They are not only expensive but have also failed to provide any continuity of patient care – most patients are followed up by their GPs the following day!

My concerns are not only resource-based – I also feel engagement between managers and GPs suffers as a result. We need to work together for the common goal of care for our patients, in light of recent cuts and efficiency drives made across the NHS.

From Dr Krishna Chaturvedi
Southend-on-Sea, Essex