GP workforce crisis could force 600 practices to close, warns RCGP

Up to 600 practices could close within the next year because of the GP workforce crisis, the RCGP believes.

Dr Maureen Baker: practice closure warning
Dr Maureen Baker: practice closure warning

New research from the college estimates that the recruitment and retention crisis in general practice threatens to force 543 practices in England alone to shut down in the next 12 months, with up to 600 at risk across the UK.

RCGP data show that over 90% of GPs working in these practices are aged over 60.

The research found:

  • More than 1,000 GPs will be leaving the profession on an annual basis by 2022.

  • Around 22% of GPs in London could step back from front-line patient care within the next five years (with 41% of London GPs aged over 50).

  • The number of unfilled GP posts has nearly quadrupled in the last three years (2.1% in 2010 compared with 7.9%  in 2013).

New deal for general practice

Addressing college’s annual conference on its opening day in Liverpool on 1 October, chairwoman Dr Maureen Baker will demand a ‘new deal’ rescue package of incentives for GPs to work in under-doctored areas, and to ease the bureaucratic burden for returners.

The college is calling for 8,000 more full-time equivalent GPs by 2020 to cope with the demands of the ageing population.

RCGP leaders estimate that England needs nearly 40,100 GPs to meet increasing demand, 25% more than the current level of 32,075. In 2009, there were 32,110 GPs.

Dr Baker will compare general practice to the ‘walls of a dam’ preventing the rest of the NHS being flooded.

She will say: ‘So far, much of the damage to the dam wall has been hidden from the public – they see the flooding downstream in accident and emergency departments and in hospital pressures, but they haven’t  been aware that  GPs, nurses and practice teams have been absorbing that pressure by trying to do more and more with less and less.

GP 'dam' could collapse

‘But if we let that situation continue we will see whole chunks of the dam fall apart when practices have to shut their doors.

‘Every practice closed is a loss to a local community. Not only do patients lose out, but it piles more pressure on neighbouring practices, swelling patient lists already bursting at the seams.

‘We all know about the 98 practices in England, identified by NHS bosses that are at risk of closure due to the removal of the minimum practice income guarantee.

‘Today I can reveal new estimates from the college that 543 practices in England are at risk of closure if something isn’t done.

‘There are practices that have over 90% of GPs over the age of 60, when the average retirement age of GPs is 59 - this is  shocking.

‘With a growing, ageing population, not to mention a baby boom, we need to increase capacity in general practice, not take it away.

Practices should be expanding

‘If this was a business it would be expanding to meet demand – not shutting down services and closing branches.'

Dr Baker will say that in the face of relentless workload pressures and constant attacks from the media, ‘we are not attracting enough new doctors and nurses into general practice, or doing enough to retain the highly skilled workforce we have’.

‘All of these developments result in further weakening of the dam. Colleagues, the wall of the dam – the service of general practice – is under huge pressure and unless urgent action is taken to repair and restore the dam, it could burst with terrible consequences for our patients in general practice and indeed for the whole of the NHS.

‘Let’s continue to make our voices heard and demand a new deal for general practice.’

On Tuesday health secretary Jeremy Hunt announced plans to train and retain 5,000 extra GPs as well as £500m funding to roll out 8am til 8pm and weekend appointments.

Last week Labour said it would recruit 8,000 using a £2.5bn funding injection. It also plans to spend £100m to guarantee appointments within 48 hours.

Andy Burnham MP said the latest research from the RCGP ‘completely undermines David Cameron's party conference rhetoric’.

‘The truth is that this prime minister has presided over a crisis in general practice and collapse in GP morale. 

‘People are already struggling to get GP appointments and these figures suggest things are about to get even worse, not better, if hundreds of surgeries close for good. 

‘This is a problem of the prime minister's own making and he must urgently produce a convincing plan to sort it out. Unfunded, unrealistic party conference promises are not good enough. Patients must not be left travelling miles to see their GP or waiting weeks for an appointment.’

GP will be reporting from the RCGP annual conference on Thursday and Friday. Follow @coopercolin, @NeilDurham, @davdmillett on Twitter for news from Liverpool.

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