A motion backed unanimously at the BMA annual conference in Brighton on Tuesday called for more action to raise public awareness of the 'mounting threat' to general practice.
It warned that unmanaged dispersal of patients when practices close can undermine safety, called for transparency around contracts for providers brought in to replace practices that close, and for protection for GPs left as the 'last man standing'.
East Midlands GP Dr Annapurna Rao, who proposed the motion, told the conference: 'It’s deeply concerning that practice closures are becoming increasingly common. General practice is the backbone of the NHS. If this collapses, our beloved NHS will crumble.'
Practice closures
South-west England GP Dr Miriam Ainsworth said: ‘Practice closures have a number of consequences... The unmanaged dispersals of [patients] when practices close put additional pressures on other practices which have to accomodate the displaced patients. Without additional resources to allow practices to gear up to cope with the increased demand, the additional pressures on doctors are certain to mean that the quality of practice suffers and patient safety is compromised.’
Dr Ainsworth also urged the BMA to take action to financially protect doctors who are left either without support or without a job due to the workforce shortage. This is referred to as a ‘last man standing’ situation.
‘Protection from any additional costs of resignation or retirement resulting from practice closure are essential,' she argued. ‘As I know from my own experience of being placed in this situation several years ago, the cost can be considerable including practice debts, staff redundancies, etc.
‘Unless the last man standing is fortunate enough to arrange a merger with another practice or buy out with another practice, discharging these liabilities falls to the last partner. Protection advocated in this motion is essential.’
Public awareness
Increased public awareness of the ‘incremental decline’ of general practice was essential to force the government to address problems faced by primary care, she warned - echoing a vote at the UK LMCs conference in February.
GPC chair Dr Richard Vautrey said: ‘Over 1m patients have been affected by this situation with practices closing in recent years and the last person standing issue is fundamentally undermining the partnership model of working. That’s why it is central to the partnership review that’s taking place at this moment.’
In 2017/18, more than 250 practices were closed or merged in England. The latest national GP worklife survey, carried out by the University of Manchester and published earlier this year found that a record number of GPs were planning to quit in the next five years.
Click here to read Dr Vautrey's speech at the 2018 BMA annual conference in full
