In a letter to a top NHS official, GPC chairman Dr Chaand Nagpaul set out proposals to help the growing number of practices at risk of closure or destabilisation caused by resource, recruitment and workload pressure.
Dr Nagpaul's letter to director of NHS commissioning Ros Roughton last week said practices should be able - like A&E departments - to declare a capacity shutdown in response to a ‘major incident’. Practices facing a crisis should have the power to close their patient list and access to emergency resources, the GPC chairman said.
Dr Nagpaul said that long-term efforts to address the problems affecting practices, such as training additional GPs and using workforce and technology more creatively, 'will unfortunately prove too little, too late for many of the worst-affected practices’.
GP practice closures
‘We know that acute problems can strike practices with little warning, affecting patient services and staff wellbeing and at worst leading to practice closure which has knock on effects for patient care, neighbouring practices and local NHS costs. The Annual Conference of LMCs this year asked us to explore mechanisms with Government to stabilise general practice in localities where sudden practice closures are likely to occur.
‘I am writing to formally request a meeting with NHS England to discuss how we might proactively identify, support and stabilise practices that are vulnerable to these pressures or at risk of becoming vulnerable. We believe that a significant number of practices are outwardly coping but have fragile foundations which could easily collapse if the practice experiences any additional pressure, for example through staff sickness or retirement.’
Dr Nagpaul added: ‘We believe that the short-term costs of all of these measures could easily be dwarfed by the costs to the NHS of allowing good practices to collapse.'
The GPC chairman's letter called for practices to have access to a ‘non-threatening’ report funded by NHS England to assess their vulnerabilities. Practices found to be at risk should have access to appropriate support in the form of management resources, clinical input, or transitional funding, it said.
The GPC also called for every area to establish a ‘healthcare resilience taskforce’ to respond to practice crises.
NHS England, Dr Nagpaul added, should offer tangible support for GP network development to promote primary care infrastructure at scale.