Dr Malcolm Ward, chairman of the RCGP's rural forum steering group, said the plans would create problems for all GP practices. But they would be ‘more extreme the more rural the practice', he said.
In the forum's response to a DoH consultation, Dr Ward said getting rid of practice boundaries will mean urban practices see a sudden increase in list size.
‘This may put a strain on rural practices whose numbers become less viable, yet the remaining population will be the needy, sick, frail and elderly,' he said.
The DoH consultation, launched in March, sets out four possible options to offer patients more choice.
These include allowing patients to register with any practice, but distinguish between local patients and patients registering further away; maintaining the requirement on GPs to make home visits to all patients, regardless of where they live; allowing people to register with two GP practices; or making PCTs responsible for home visiting arrangements.
Dr Ward said there were ‘more practical and cost effective solutions'. PCTs could be given the power to encourage practices to have more flexible boundaries in areas where there are particular problems, or incentivise practices to provide extended hours in areas where there is a need.