New Models of Primary Care and the future of general practice: less continuity of care… bigger surgeries…. more foreign trained doctors?

The Nuffield Trust has published a report downloadable from their website…

Is General Practice in Crisis? New briefing and survey report. In a policy briefing published today, the Nuffield Trust reviews the available data on the state of general practice. The briefing shows that there is a looming staffing crunch affecting GPs and calls for better data on consultations. It argues that GPs need to join with other practices and healthcare professionals to meet the different needs of their patients.”

It’s ironic that as GP practices close, and patients have to travel further and spend longer on waiting lists, that the government called the health services “patient centred”. North and South, East and West, in cities and in rural areas the closures are really happening. It’s all very well for politicians whose nearest and dearest may well have private cover, and who are often not aware of the real world. The poor manpower planning over many years has led to this catharsis. The one thing a doctor does that no-one else does is “Make a Diagnosis” and if he fails in this, and refers or investigates inappropriately he is wasting money and resources, and increasing waiting times. Unfortunately the blame society wants a scapegoat. GPs are tempted to offload in the current climate. Even the Nuffield Trust may not be emphasising the political imperative for a solution which is long term and avoids collusion of denial.. There is less continuity of care, in larger practices, with more and more part time GPs. There will have to be an importation of new doctors from countries who can least afford to lose them..

Nick Triggle for BBC News 2nd October 2014 reports: Ageing GPs ‘may force practices to close’ followed on 14th October by: Failing GP practices face closure and now today 4th November: Is there really a crisis among GPs?

Victoria Chessum in Kentonline 4th August 2014: Patients concerns over future of Dover Medical Practice forwarded to Health Secretary, Jeremy Hunt

BBC News and Kentonline 4th November 2014: Dover Medical Practice to close as private firm pulls out

Nick Sommerlad  for the Mirror December 13th 2013 reported: England’s best-rated GP surgery under threat of closure thanks to NHS budget cuts

Nick Lavigueur  for the Huddersfield Daily Examiner September 11th 2014 reports: Huddersfield and Dewsbury GP closures leaves hundreds without a doctor

Lucy Johnstone in the Express Sunday 2nd February 2014 reports: Closure fears for surgeries with 8,000 patients to one GP

Ian Bunting in The Daily Record (Scotland) 20th February 2014 reports: Airdrie village GP surgery closure? Landlord claims NHS Scotland to blame 

The Edinburgh News 13th March 2014 reports: Struggling GP surgeries turning away new patients

Rachael Misstear  for Walesonline 17th October Health board blasted for closing Aberaeron GP surgery

Pulse reporters Christina Kenny, Jaimie Kaffash, Alex Matthews-King on 3rd July 2014 report: Sixty GP practices across the country facing imminent closure

Exclusive Around 60 practices across the UK are facing imminent closure due to issues over funding and recruiting staff, Pulse has learnt.

In a measure of the recruitment crisis and funding squeeze facing the profession, local GP leaders have warned that they are witnessing an increase in the number of practices considering giving up their contracts altogether.

Pulse surveyed 25 local GP leaders from across the UK, and found that 60 practices were either notifying their patients about their closure or were in talks about relinquishing their contract.

The leaders of local medical committees (LMCs) or GPC representatives told Pulse that they fighting to keep practices open, but were facing a ‘slow train crash’.

They also cited the ‘domino effect’ that would occur if practices were allowed to close and large numbers of patients had to be reallocated to other neighbouring practices.

The BMA warned in May that practices were ‘imploding’ with the pressure on them, and that was leading to many being at risk of closure.

The survey found:

  • In Gloucestershire, three practices are under imminent threat of closure with GPs at one taking home no pay at all.
  • Six practices in Hampshire have been in discussions with LMC representatives about relinquishing their contracts.
  • One practice in Oxfordshire has closed this week because it could not afford the running costs, another is due to close due to a lack of investment in premises.
  • In Wales, four practices are closing imminently, and a further 10 are considering doing so due to recruitment problems.

Gloucestershire  LMC chair Dr Philip Fielding said: ‘We’re working with the area team and CCG to find a way of keeping them viable, and also to keep planning succession.

‘In one practice, the partners are taking no drawings. They are retired in terms of the NHS pensions, but they’re staying on for nothing to look for a successor. In another practice, the salaried doctors are earning more than the partner. It’s inherently unstable – it’s like trying to stop a slow train crash.’

Rebecca Smith, for the Telegraph 30th September 2014 raised the stakes: Up to 200 ‘dangerous’ GP surgeries face closure under inspection regime

Dozens of GP practices that are failing to provide safe care could be closed down under a new inspection regime, chief inspector of family doctors says

BBC News 2nd November reports: GP funding ‘putting patients at risk’ in Scotland and this is universal

Even more “improvements” are planned: Chris Smyth in The Times 2nd November 2014 reports:

Doctors told to admit their mistakes 

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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