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Letting practices ‘wither’ is a complete dereliction of duty



After months and months of Pulse highlighting the plight of hundreds of vulnerable GP practices across the country, now this.

Pulse and the BBC have obtained a leaked briefing note from an NHS England director in Yorkshire and Humber that reveals a secret strategy to allow practices to ‘fail or wither’.

‘We are no long in a position to continue to support practices irrespective of their willingness to transform,’ it says.

What a scandal. A complete dereliction of duty. Each practice that closes is a tragedy, for the partners and the patients, and is a further kick to the knackers of a health service that is already struggling to cope.

You cannot tell them to ‘transform’ when they are struggling to survive. Transforming takes head-room, time to think and plan.

Look at this one in Warwickshire: the partners are being forced to choose between taking out significant personal loans or declaring bankruptcy to cover the liabilities they have been left with after handing back an unsustainable contract.

Do you really think they were saying towards the end: ‘Hm, how about a bit more social prescribing?’

NHS England says the leaked document does not reflect national policy, and to his credit, Dr Arvind Madan, director of primary care at NHS England, did admit errors, telling the RCGP’s annual conference that they had not been good at ‘getting the money out the door to practices that are in trouble’.

But practice closures have hit a three-year high, with 200,000 patients displaced last year and, as Pulse recently revealed, a £10m national fund for vulnerable practices has been tied up in so much red tape it has yet to reach the front line.

As Dr Zoe Norris points out in her blog today, NHS bosses have a choice here. They have the funds from the GP Forward View so there is no excuse for holding onto them and not passing it onto practices in trouble.

Because if they don’t, then the implication will be clear. They wanted it that way.

Nigel Praities is editor of Pulse