Closing lists may be 'only way to ensure patient safety', GPC warns Jeremy Hunt

GPC chair Dr Richard Vautrey has written to health secretary Jeremy Hunt warning that GP practices are prepared to close their lists to new patients if workload, funding and staffing pressures are not addressed.

GPC chair Dr Richard Vautrey
GPC chair Dr Richard Vautrey

The GPC has demanded the health secretary take action to fix a raft of unsustainable pressures facing the profession, in a letter sent to DH headquarters this week.

Dr Vautrey called on the DH to implement ‘a swift resolution to the indemnity crisis’, establish safe workload level limits, expand the GP workforce, support practice premises development and sustainability and ensure adequate funding reaches frontline services.

It follows a BMA survey of almost 2,000 practices which revealed 54% would consider temporarily suspending new patient registration and 44% would be in favour of applying for a formal and permanent list closure from NHS England.

Dr Vautrey said the ‘worrying’ results demonstrated the ‘huge pressures’ facing general practice.

‘GPs would only consider such action as a final recourse,’ he said in the letter to Mr Hunt. ‘We have, unfortunately, seen this borne out with recent announcements of practices having to close their lists.

‘We are deeply concerned that this survey demonstrates practices are reaching the point where closing their lists seems the only viable way to ensure patient safety.’

GP pressures

He asked to meet with the health secretary ‘over the coming weeks’ to discuss the urgent challenges that has led GPs to this position.

He wrote: ‘It is crucial that the government tackles the issue of recruitment and retention within general practice, as this is fundamental to enabling practices to meet the growing needs of their patients.

‘Rising indemnity costs, and the substantial differential (often around £10,000 or more) between primary and secondary care indemnity fees are not just adding to the severe financial difficulties felt across primary care, but further exacerbating the existing primary care workforce crisis.

‘Prohibitive indemnity costs can be a contributing factor in GPs reducing their hours, limiting their ability to work in urgent care settings, or impacting their decision to work beyond retirement age or choosing to retire early.

‘In addition, it is a major rate limiting factor for the expansion of the multidisciplinary workforce in and around general practice. A new system is required for primary care which is comparable and equitable with secondary care, and takes this current huge burden away from GPs.


Dr Vautrey also highlighted that funding increases were failing to deliver improvements to practices. ‘Despite commitments made in the GP Forward View, increased resources are failing to reach frontline primary care services in a way that makes a tangible difference,' he wrote.

‘BMA research shows that despite some welcome increases in funding allocations for general practice, health service spend on primary care is lower now, 7.9% of overall NHS investment, than in 2005/6, when it was 9.6%.

‘Furthermore, funding commitments made to support much needed practice premises developments are not being delivered, with many practices reporting significant delays and bureaucratic barriers preventing them improving or expanding their premises to provide better care for their local population.

‘With unprecedented patient demand, a recruitment and retention crisis, huge workforce shortfalls and major practice premises problems, it is no wonder that GPs are having to consider action such as suspending their patient lists.'

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