Bristol's Charlotte Keel Medical Practice is the latest in a long list to succumb to soaring pressure on general practice in recent years - GPonline reported in July that practices serving almost 3m patients across England had closed or merged since the start of the 2013/14 financial year.
With a list size more than double the national average, it provides further confirmation that large practices are not immune to the pressures facing GPs. LMC leaders in Plymouth warned earlier this year that GP services across the entire city were at risk of becoming unviable after a provider serving 22,000 patients quit.
Meanwhile, GPonline reported earlier this year that more than one in four GP partners did not believe their practice would survive another five years.
> Map: GP practice closures and mergers
Partners at the Charlotte Keel Medical Practice, in one of Bristol's most deprived areas, were forced to hand in their notice because they face cuts to baseline funding worth £150,000 a year under PMS contract reviews. Changes to premises costs could bring a further' £100,000-£160,000 a year' hike in costs, the practice says.
A statement from NHS England says that partners at another practice in the area - the 10,000-patient Bishopston Medical Practice - have also decided to resign from their contract.
A statement released by partners at the Charlotte Keel Medical Practice said that its patient population faces 'considerable health inequalities due to high levels of deprivation', and because many do not have English as a first language, and/or have complex mental, physical and social health problems.
'Historically these inequalities have been recognised by NHS commissioners buy the provision of both additional funding and reduced charges for the occupation of an NHS-owned health centre,' the partners' statement reads. 'This additional financial support has allowed the practice to meet the needs of its patients by employing more doctors and nurses per patient than the average practice.'
However, despite evidence that atypical practices' needs are not met by standard GP funding, the practice says that to date, 'NHS England and Bristol CCG have not offered any funding to meet the costs of these additional workload challenges'.
The partners will quit the practice from 31 March 2018, with local service provider BrisDoc confirmed as the preferred option to take over. NHS England's statement said that BrisDoc could take over the Bishopston Medical Centre from as soon as February.
NHS England said the transfer to BrisDoc was a 'tried and tested way of stabilising practices so the NHS can work with patients to look at the options for the longer term'.
'Business as usual'
NHS England South West Commissioning Director, Debra Elliott, said: 'We are absolutely committed to securing the best care for patients at Bishopston and Charlotte Keel. While we urgently finalise arrangements for a replacement management team, it will be business as usual at the surgeries.
'We’ll then work closely with patients, staff and other stakeholders on what services are needed for the future.'
Bristol CCG chair Dr Martin Jones said: 'We’re working closely with NHS England to find a long-term solution for patients at the surgeries. The long-term solution goes hand in hand with the work we are doing across Bristol, North Somerset and South Gloucestershire to increase sustainability of primary care by supporting GP practices to work closer together.'