GP leaders called on the government to take urgent action to address the crisis in the service after practices voted in favour of action.
Practices were asked to say whether they would be prepared collectively to temporarily suspend new patient registrations and/or apply to their commissioner for a formal list closure, as a form of industrial action.
The decision to ballot the profession was agreed by LMC representatives at their annual conference in Edinburgh in May in response to the failure of NHS England’s GP Forward View to deliver resources to sustain the service.
GP list closure
Of 1,870 practices which voted, 54% said they were prepared to take both forms of action.
GPC chair Dr Richard Vautrey said: 'The fact that even a single surgery has reached the point where it would consider a suspension of new patient registration or closing its patient list fully shows that government promises to rescue GP services have failed to materialise.
'Despite the hard work of GPs, nurses and practice staff, many GP practices are struggling to cope with the rising number of patients coming through their doors because of a lack of necessary funding and widespread staff shortages. A third of GP practices have told the BMA they have had vacancies that have gone unfilled for 12 months and nine out of ten have said their workload is often unmanageable.
'This is placing an intolerable pressure on local GP services, especially as they increasingly need to deliver intensive, specialist care in the community to the growing number of older patients with complex health conditions. In recent years some GP practices under considerable pressure have already taken the step of suspending their practice list in order to maintain patient safety.
'The government needs to understand that this landmark survey sounds a clear warning signal from GPs that cannot be ignored, and that the workload, recruitment and funding crisis in general practice must be addressed with far more vigour and commitment. Practices believe the promises in the GP Forward View which pledged to provide more resources to frontline patient care have failed to make an impact. The BMA is now calling on ministers to work with us to urgently to address this growing crisis which is threatening to overwhelm general practice. We cannot allow a situation where patient safety is being compromised by a lack of political action.'
Doctors in Unite representative on the GPC Dr Jackie Applebee, who proposed the motion for list closrures at LMCs conference said: 'This result underlines in bold that the majority of GP practices in England feel the need to take drastic action to manage their workload and ensure the safety of their registered patients.
'I hope this clear signal finally brings home to the government that the situation is extremely serious and that they need to act immediately to turn this around. A group of us suggested eight things the government could do straight away to help when we wrote our FAQs at the start of the ballot. There is far more to be done than that but it would be a start and would show that when they say that General Practice is the jewel in the crown of the NHS that they mean it and that these are not just empty words.'
An NHS England spokesman said: 'While only a minority of practices responded to this ballot, the pressures they report are real which is why theres going to be an extra £2.4bn of annual funding going into general practice.
'It’s also why- just over a year into the five-year action plan - we've hired hundreds of new clinical pharmacists and mental health therapists working alongside GPs, and we've kicked off a major International recruitment programme for at least another 2000 family doctors. We also are working with the GPC and others on further action to address some of the immediate pressures in areas such as GP indemnity.'
RCGP chair professor Helen Stokes-Lampard said: "That practice-list closures on a wide scale are even being considered is an indication of just how pressurised general practice is at the moment – and how downtrodden GPs and our teams across the country are feeling.
'No practice would ever consider closing their list to new patients if they were not seriously concerned about their ability to cope with their increasing workload and deliver care to patients safely.
'The RCGP has shown numerous times over the last few years that nowadays, UK family doctors making 60 patient contacts a day is commonplace – and that they are routinely working intensive 11-hour plus days in clinic. GPs who are fatigued are more likely to make mistakes – so these working conditions are potentially a risk to our patients’ safety.
'The results of this survey are a call for help. We need the pledges in NHS England’s GP Forward View – including £2.4bn extra a year for general practice and 5,000 more full-time equivalent GPs – delivered in full, and as a matter of urgency.'