GP leaders have warned that patient care “from Cumbria to London's East End” is under “imminent threat” because of a lack of financial support from the NHS, with a number of practices facing the prospect of closing down.
Dr Chaand Nagpaul, chair of the GP committee of the British Medical Association, has written to NHS England chief executive Simon Stevens calling for national action to support surgeries affected by cuts to their funding introduced last year.
In 2013, NHS England identified 98 GP practices at risk of closure following decision to scrap the minimum practice income guarantee (MPIG) - top up payments which were introduced in 2004 to ensure that no individual practice dipped below its historical funding levels after changes to the GP contract that year.
The practices were pledged financial support to save them from closure, but Dr Nagpaul said that, one year on, no “meaningful support structure” was in place.
His letter said: “We have been contacted by a number of practices, both in and outside the 98 identified outlier practices, who have been informed by their Area Teams that they are not able to provide such support, either due to funding problems or a lack of central direction.”
The letter comes as academics warn that the Government's strategy to improve access to GP services by extending opening hours may not be the most effective way of guaranteeing patients an appointment with their doctor.Research carried out at Cambridge University's Institute of Public Health concluded that improving access to GP appointments during standard working hours would be more effective.
The findings, published in Emergency Medicine Journal, are based on an analysis of 567,000 responses to the annual English General Practice Patient Survey. The study found that patients who worked part-time, or were not in work or education, who were therefore free to see their doctor in normal working hours, were nonetheless the most likely to attend out-of-hours NHS services instead. The researchers said that this suggested the problem lay not in the hours worked, but in the number of appointments available during these hours.
GP leaders have said that ambitious Government plans for practices to open from 8am to 8pm and also offer weekend appointments, as well as providing an enhanced service and same-day consultations for the over 75s, will be impossible without significant extra investment in general practice.
Despite being responsible for around 90 per cent of patient contacts within the NHS, GPs receive less than nine per cent of NHS cash - a share which has been falling in recent years.
Commenting on the Cambridge study, a Department of Health spokesperson said: “People need to see a GP when it suits them which is why we've just introduced a new £50m fund which will offer millions more patients evening and weekend appointments as well as email and Skype consultations. From October, people can also register with a GP practice outside their local area, such as their workplace.”
Responding to Dr Nagpaul's warning, an NHS England spokesperson said the NHS would work with what it called the “very small number of practices” affected.
The spokesperson said: “MPIG unfairly takes money from GP practices with the heaviest workloads and the sickest patients so perpetuates health inequalities which is why this temporary measure is slowly being phased out over 17 years since it was first introduced.”