Exclusive: Majority of GPs ready to close lists in workload protest

More than half of GPs are ready to participate in a mass closure of patient lists to highlight the crisis facing general practice, a GPonline poll suggests.

A total of 54% of 583 GPs who responded to a question on list closure said they would be prepared to 'take part in plans for GP practices collectively to close their lists' in protest at the crisis facing general practice. Just 20% said they would not, with the rest unsure.

Significantly, among 235 GP partners who responded to the question 60% said they would be prepared to take this step, with just 19% not prepared to do so.

One partner responding to the poll wrote: 'Actively considering this now and may be forced to do this in order to avoid collapsing ourselves under the pressure of weighted list size and shortage of staff.'

GP list closure

The finding comes after GP leaders at last month's LMC conference 2017 in Edinburgh backed a motion calling for the GPC to 'ballot GPs as to whether they would be prepared to collectively close their lists' in response to the crisis facing general practice.

LMC leaders backed calls for a ballot despite a warning from the GPC that collective list closure would be a likely breach of contract, and that a ballot could mean 'the BMA could be seen to be promoting that breach'.

Motions for debate at this month's BMA annual representative meeting (ARM) also highlight pressure facing GPs, with doctors' leaders set to debate a call for practices to be able to declare a hospital-style 'black alert' to indicate that they have reached their maximum safe capacity. The BMA will be urged to 'construct such a system with or without government co-operation'.

A similar demand has been put forward by BMA leaders in Yorkshire, who will propose a motion highlighting concern 'at the increasing numbers of practices struggling to provide a safe and sustainable service'. The ARM will be urged to back plans for practices to 'self-declare a safety alert when they have reached capacity on any specific day', with patients then diverted to alternative services such as A&E or local walk-in centres.

Patient safety

Despite majority support for collective list closure, many GPs expressed concern about the impact on patients. Some said closing lists would be unethical, while others said they would only take part if effective measures to protect patients were put in place. Others were concerned that list closure could alienate patients.

Some felt that workload pressure had left them with no choice, however, with one retired GP saying his practice had already closed its list unofficially. Another said simply: 'Some form of industrial action needs to be taken.'

Both the RCGP and BMA have previously called for measures to help practices declare that they are facing extreme pressure. Former RCGP chair Dr Maureen Baker said in July 2015 that practices needed a 'distress signal' similar to the hospital alert system, just weeks after a warning from GPC chair Dr Chaand Nagpaul about soaring pressure on practices.

Dr Nagpaul also called for practices to have the power to shut down capacity and call on emergency back-up if they were close to collapse because of the toxic mix of underfunding, recruitment problems and rising demand.

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