More than half a million UK patients had to change their GP practice last year as a result of their surgery going under or merging with another practice to cope with rising workloads, an investigation has found.
At least 138 surgeries across the UK shut their doors in 2018, meaning up to 519,000 patients may have been displaced.
This compares to 134 in 2017, and just 18 which were found to have closed in an equivalent investigation in 2013.
GP leaders said that closures were typically a last resort, where the loss of other partners had left one doctor unable to recruit full-time staff and no way to maintain safe care.
Of the 138 closures identified in the investigation by the magazine for GPs Pulse, 31 were as a result of mergers and affected 161,126 patients.
In these cases patients may have been able to keep their original GP, but may have had to travel further afield to a new site.
Medical leaders said this could undermine patient satisfaction.
“The system is creaking,” said Dr Jackie Applebee, the chair of Tower Hamlets local medical committee.
“Smaller practices – which patients prefer and which have good outcomes – are being lost because of the under-resourcing.”
The investigation used freedom of information requests to all 217 NHS clinical commissioning groups (CCGs) in England and health boards in Wales, Scotland and Northern Ireland, of which 186 replied.
It comes as official figures from NHS Digital reveal the number of GPs in England has fallen to 28,697 full-time equivalent qualified GPs, a drop of 441 from March 2018.
NHS England stressed that full-time equivalent numbers have risen by 312 doctors if those in training to become GPs are included.
There are now more than 7,000 additional nurses, pharmacists and other non-medical staff working in GP practices since a pledge to increase numbers in 2015.
However, the government has made little headway on its pledge to increase the number of doctors in general practice by the same amount – after losing 1,000 GPs so far.
The latest figures show the NHS is continuing to haemorrhage the most experienced doctors, who are quitting and reducing their hours as a result of unchecked workload and pension changes which have left many facing significant tax bills if they work too many hours.
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said the losses were “heartbreaking” and further closures must be avoided “wherever possible”.
Some practices may be merging to pool resources and provide more services, she said.
“But when a practice closes because resource and workforce pressures mean that it is no longer safe or sustainable to keep running, it’s incredibly serious – and heartbreaking for everyone involved, especially those patients who have to travel long distances to their new surgery,” she added.
An NHS England spokesperson said it could not comment directly on Pulse’s figures as it only has details for English CCGs, and nothing after March 2018, but it disputed that the issue was getting worse.
“In England there were fewer practice closures and patient dispersals in 2017-18 compared with 2016-17 and we continue to support all general practices to help them thrive,” they said.
“Thousands of practices continue to be helped through the GP resilience programme, where investment has been increased from a planned £8m in 2019-20 to £13m.”
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