Over 500 surgeries at risk of closure as GP workforce crisis deepens

Publication date: 02 October 2014

RCGP figures show surgeries could be forced to close in the next year

Up to 543 GP practices in England – potentially rising to nearly 600 across the UK – could be forced to close within the next year because of a deepening crisis in GP recruitment and retention, which is leaving many practices unable to replace family doctors who are retiring from the profession.

New figures released by the Royal College of General Practitioners show that over 90% of the GPs working in these practices are now aged over 60.

Unless drastic action is taken to make sure that there are enough doctors to take their place, thousands of patients could be forced to travel miles to their nearest GP practice or be left stranded with no family doctor at all.

The alarm bells for the future of patient care will be sounded by Dr Maureen Baker, Chair of the RCGP – the UK’s largest network of 50,000 family doctors – in her inaugural speech to the College’s national conference in Liverpool this Thursday.

Addressing an expected audience of over 2,000 GPs and health professionals, Dr Baker will warn that the crisis in the GP workforce is now so severe that the number of people entering the profession is falling drastically short of the number of GPs who are leaving in their droves to take early retirement, work abroad or pursue entirely different careers.

So desperate has the situation become that the RCGP estimates that:

  • More than 1,000 GPs will be leaving the profession on an annual basis by 2022
  • Around 22% of GPs in London could step back from front line patient care within the next 5 years (with 41% of London GPs being over 50)
  • The number of unfilled GP posts has nearly quadrupled in the last three years  (2.1% in 2010 to 7.9%  in 2013)

Meanwhile, it was estimated in March that applications to undertake GP training had dropped by 15%, with only 40% of medical graduates choosing to enter general practice training – as opposed to training for other specialties – despite a national target to ensure that by 50% of medical graduates go into general practice.

Dr Baker will demand a rescue package – a ‘new deal’ – for general practice that includes cutting back on the bureaucracy that currently prevents qualified GPs from returning to work after a career break, and specific incentives to encourage more doctors into deprived areas, that are currently under-doctored.

The North West and North East regions are the most under-doctored regions of England, with 63.4 and 63.6 GPs per 100,000 population respectively.

The College estimates that with a growing and ageing population, in which increasing numbers of people have multiple long-term conditions, the GP workforce needs 8,000 more FTEs by 2020.

While the RCGP estimates that England needs nearly 40,100 full-time equivalent GPs in order to meet increasing patient demand, there are in fact just 32,075 family doctors. In 2009, there were 32,110 GPs.

Overall, she will reiterate the RCGP’s call to all four governments of the UK to increase the share of the NHS budget for general practice – currently at an historic low of just over 8% – to 11% by 2017.

Every day, GPs and their teams carry out 1.4m consultations and over 90% of patient contacts within the NHS are managed in general practice.

GPs and their teams are now seeing 370m patients a year – nearly 60m more than even five years ago – with many GPs now routinely working 11 hour days and seeing 60 patients in a day to try and meet demand.

Comparing general practice to the ‘walls of a dam’ that prevents the rest of the NHS being flooded, Dr Baker will say:

“So far much of the damage to the dam wall has been hidden from the public – they see the flooding downstream in accident and emergency departments and in hospital pressures, but they haven’t been aware that GPs, nurses and practice teams have been absorbing that pressure by trying to do more and more with less and less.

“But if we let that situation continue we will see whole chunks of the dam fall apart when practices have to shut their doors.

“Every practice closed is a loss to a local community. Not only do patients lose out, but it piles more pressure on neighbouring practices, swelling patient lists already bursting at the seams

“We all know about the 98 practices in England, identified by NHS bosses that are at risk of closure due to the removal of the minimum price income guarantee.

“Today I can reveal new estimates from the College that 543 practices in England are at risk of closure if something isn’t done.

“There are practices that have over 90% of GPs over the age of 60, when the average retirement age of GPs is 59 – this is shocking.

“With a growing, ageing population, not to mention a baby boom, we need to increase capacity in general practice, not take it away.

“If this was a business it would be expanding to meet demand – not shutting down services and closing branches.

She added:

“Most worryingly, in the face of relentless workload pressures and constant attacks from the media, we are not attracting enough new doctors and nurses into general practice, or doing enough to retain the highly skilled workforce we have.

“All of these developments result in further weakening of the dam. Colleagues, the wall of the dam – the service of general practice – is under huge pressure and unless urgent action in taken to repair and restore the dam, it could burst with terrible consequences for our patients in general practice and indeed for the whole of the NHS.

“Let’s continue to make our voices heard and demand a new deal for general practice.

“And a new deal for every single patient in Wales, in Northern Ireland, in Scotland and England.”

Further Information

RCGP Press office: 020 3188 7574/7575/7581
Out of hours: 0203 188 7659
press@rcgp.org.uk

Notes to editor

The Royal College of General Practitioners is a network of more than 50,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

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