Exclusive: More than one in twenty GP contracts terminated in three years as closures accelerate

More than one in 20 GP practice contracts in England have been terminated since 2013, official data obtained by GPonline reveal.

Figures from NHS England’s local commissioners show the full extent of the contract chaos inflicted on the service since the health service reforms of three years ago.

One GP leader said the figures confirmed the extent of the ‘catastrophe’ engulfing general practice.

Subregional figures, obtained using the Freedom of Information Act, reveal for the first time the full and escalating extent of disruptive practice closures, mergers and takeovers.

GP contracts

Commissioners provided details of 140 practice contracts that had been terminated because of a practice closure between 1 April 2013 and 21 March 2016. The number of closures more than doubled from 26 in 2013/14 to 59 the following year, with a further 55 before the end of last year.

A further 264 contracts were identified as having been merged over the three-year period. More detailed information from some areas indicated that around half of those practices involved in mergers may have been closed.

The data on contract terminations revealed a further 26 practices that had been reprocured under a new contract. Of these 11 GMS and five PMS practices were handed to an APMS provider.

The total number of contract terminations - in which practices closed or merged - increased from 54 in 2013/14 to 158 the next year and up to 192 before the end of 2015/16.

Common reasons for closures provided by commissioners included GP retirements and contract resignations.

GP crisis

GPC contracts subcommittee chairman Dr Robert Morley warned the crisis would get worse as more GP principals retire.

Analysis of the contract types affected shows 71 GMs and 21 PMS were closed over the period, while 173 GMS and 76 PMS were merged.

London was hardest hit with 72 terminations recorded over the period - 39 closures and 33 mergers, followed by south-east England with 45 terminations, and Yorkshire and Humberside with 44.

NHS Digital figures have shown that the total number of GP practices fell by 201 between 2014 and 2015.

GPC chairman Dr Chaand Nagpaul told LMC representatives at their annual conference in May that practices closures had reached ‘record numbers’.

GP workforce

Dr Morley said: ‘These figures really do confirm the extent of the catastrophe engulfing general practice. This has not just been shroud-waving by the profession and its representatives, the unprecedented crisis is real, it’s here now and, even more frighteningly, this is only the thin edge of a very thick wedge as  it will inevitably and rapidly get worse as more and more GP retirements come on stream.

‘I would liken what has happened to general practice to a cliff that for a decade has been steadily eroded, initially invisibly below the waterline but now large chunks are visibly falling off and anytime now complete collapse is inevitable, unless the required drastic action is taken.’

The crisis, he added, had been caused by a 'deliberate' combination of ‘massive underfunding’ and damaging policies.

‘Lip service to resolving the situation is now being paid by NHS England but is still completely underestimating the extent of the crisis and the magnitude of investment and other actions required to save general practice.’

An NHS England spokesman said: ‘A practice may close for a number of reasons, including mergers to create group practices that offer a wider scope of services for patients. ‘However, we understand the pressures GP practices are facing which is why we are getting on with implementing measures to tackle these longstanding issues as set out in the £2.4bn GP Forward View.’

Photo: iStock

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