One in six GP practices have closed or merged under NHS England

One in six GP practices covering 5.4m patients have closed or merged since NHS England became operational in April 2013, analysis by GPonline shows.

Practice closures (Photo: Karl Tapales/Getty Images)

The figures suggest that nearly 10% of the registered population at that time have seen their practice merge or close in just over six and a half years since NHS England began.

Of the 8,106 GP practices listed in NHS Digital figures for April 2013, 1,284 have closed or merged - 16% of the total.

Figures for January 2020 show that there are now just 6,822 GP practices in England, with an average list size of 8,843 - 28% higher than the 6,914 average list in April 2013.

While practice mergers have contributed heavily to the sharp rise in average list size across GP practices in England, a rise in the population is also a factor.

In April 2013, 56m patients were registered with GP practices in England, compared with 60.3m in January 2020 - an 8% increase. Meanwhile, the population has aged too - with nearly 1m more people aged 70-79 now compared with April 2013, and more than 300,000 extra patients in the over-80 category - while the GP workforce remains in decline.

Numbers of GP practices with large registered populations have surged - the number of practices with more than 20,000 patients has tripled from 81 when NHS England began to 246 in January 2020.

Meanwhile, small practices - among the most popular with patients - have been disappearing rapidly. In April 2013, 3,162 GP practices had a registered list of less than 5,000 patients - while by January 2020 that figure had dropped to 1,764.

BMA GP committee chair Dr Richard Vautrey said: 'The NHS is facing unprecedented demand, and as these figures show, there’s been no let up, with the number of patients registered with GPs rising from 56m in April 2013 to a staggering 60.3m in January this year.

'Not only is patient demand increasing, but with this comes a population that is also living longer and with multiple, chronic conditions, putting an even greater strain on services, particularly primary care where the majority of patients are seen and managed.

'These figures reinforce what the BMA has long been saying – patient demand isn’t going to change, so we need a health service that can evolve and adjust to growing numbers. That’s why we need to see more funding put into the NHS to ensure it has the right resources to ensure patients continue to get the care they need and deserve, regardless of how many need our help.'

Former NHS England director of primary care Dr Arvind Madan was forced to quit in 2018 after posting comments online under a pseudonym that suggested GPs should be pleased that small practices were closing. However, he later made clear that this was not NHS England policy - and highlighted the 'vital role' small practices play.

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