Thousands of patients forced to hunt for a new GP as staffing shortages accelerate practice closures

Doctors warn of recruitment and retention crisis in medical profession

Thousands of patients have had to find a new GP because their local practice has closed, as staffing shortages and workload pressures take their toll on surgeries, new figures show.

In England, Scotland and Wales, 61 practices have closed since April 2013 which has forced more than 160,000 people to register somewhere new, figures obtained via Freedom of Information (FOI) requests show. Closures are being forced by problems both in recruiting new GPs and in retaining the existing workforce. The figures, obtained by the GPs’ magazine Pulse, were described as “the tip of an iceberg” by one senior GP.

Data released by the Government last year indicated that more than 500 practices had closed between 2009 and mid-2014. These also include practices lost through mergers and takeovers. However, a previous FOI request by Pulse revealed a sharp increase in the number of practices approaching NHS managers for formal advice about closing: 169 made such requests between April and December last year – compared with just 37 in a year between April 2013 and March 2014.

Practice closures are piling pressure on other GPs who must take on the displaced patients, doctors’ leaders said. Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, told Pulse: “There are many practices on the brink of collapse, while others are significantly reducing the level of services they can offer.

“There needs to be a national, proactive approach to support general practice to prevent this sort of issue occurring. Far too often it is a case of trying to make amends after the event.”

Some parts of England have seen especially high closure rates. In London, 22 practices shut their doors, forcing 52,000 patients to go elsewhere. In the Midlands, seven closed, affecting 27,000 patients.

Dr Robert Morley, of Birmingham’s Local Medical Committee, said the situation was “absolutely dire and getting worse”.

“We have small partnerships that are becoming unviable because of issues of recruitment, retention, impossible workload, GP illness and ‘single-handers’ [GPs running a practice alone] retiring. Practices are also being closed by the Care Quality Commission,” he said.

The East Midlands is one of the country’s “under-doctored” areas – where the NHS has been struggling to recruit new medical graduates to become GPs. Last year only 70 per cent of training places in the region were filled.

Since then the NHS has embarked on a major GP recruitment drive. New figures expected later this month will show whether or not it has had early success.

 

The GP workforce is also ageing, and the heavy demands of the job – many GPs now routinely see 60 patients a day – are forcing many to opt for early retirement. A survey by the BMA earlier this year revealed one in three are considering retirement in the next five years. The Royal College of General Practitioners (RCGP) has also warned that family doctors are leaving the profession “in their droves”.

The average age for a GP to retire is 59 and, in October last year, the RCGP identified 543 practices where all or most of the doctors are aged over 60.

In England, 2,688 GPs were recruited in 2014, leaving nearly 400 posts unfilled. In contrast, Wales and Scotland were able to fill around 90 per cent of their GP training posts. Research last year showed that only 11 per cent of new medical students planned a career in general practice – despite the Government setting a target for half of all medical graduates to become GPs.

The closures will be of concern to the new government, which has pledged to expand GP access, with all patients able to visit their surgery, seven days a week, 8am until 8pm, by 2020 – plans described by Dr Nagpaul as a “surreal obsession”.

A Department of Health spokesperson said it was taking the necessary steps to deal with the situation and denied the closures posed a threat to the plans for a seven-day GP service: “People are never displaced. GP practices have been closing, opening and merging for a long time. When a practice closes, NHS England has a responsibility to make sure patients can still get services.  We are planning to train 5,000 more GPs, invest the extra £8bn the NHS says it needs over the next five years and our plans for improving access to general practice are backed by £100m this year. 

“All this puts seven-day services for general practice firmly on track and we will set out our strategy for a new deal for GPs soon.”

Case Study: 'The doctor won’t be back'

Thousands of patients at an north London surgery have been forced to seek new doctors after their GP surgery was closed last week. Patients registered with Bingfield Street Surgery in Islington were told last month that their surgery would be closing as one of its doctors, who has been off work for the last year, would not be returning.

A further two surgeries in the area are also due to close. Mitchison Road clinic and the Holloway Road Medical Centre are both set to shut their doors next month. News of the combined three closures in the north London borough has prompted concerns within the community that too much pressure will now be placed on remaining local NHS services.

It is expected that thousands of residents will now have to re-register at surgeries in the area. The Islington Tribune described remaining resources as under pressure as the local clinics were “already struggling to cope and patients [were] waiting weeks and sometimes months for non-urgent appointments”.

A Labour councillor for Islington, Paul  Convery, told the paper he is “very, very  angry” at how the NHS has handled the closures. “Patients are being treated in a cavalier way and are being redistributed throughout the area. One local practice has had several hundred new registrations and the new patients appear quite troubled and alarmed.”

The Labour MP for Islington South and  Finsbury, Emily Thornberry, called the  situation a “mess”.

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