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GP exodus could force hundreds of practices to close in next five years, royal college warns

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k4123 (Published 28 September 2018) Cite this as: BMJ 2018;362:k4123
  1. Gareth Iacobucci
  1. The BMJ

More than 2.5 million patients in England could lose their GP practice to closure in the next five years unless urgent measures are taken to reduce the number of doctors leaving the profession, the Royal College of General Practitioners has warned.

The college said “untenable” workload pressures were pushing older GPs towards the exit door, and called for urgent initiatives to improve retention of the workforce.

The college gave the warning after conducting an analysis that found that 762 practices across the UK were at risk of closure over the next five years because they are relying on a workforce where three quarters of GPs are aged over 55. This included 625 practices in England, 71 in Scotland, 37 in Wales, and 29 in Northern Ireland.

In England, this would mean that 2.5 million people at risk of seeing their practice close. Based on its projections, the college said the five worst affected clinical commissioning group areas in England were Sandwell and West Birmingham (85 105 patients), Medway (52 330), Havering (49 761), Ealing (46 909), and Wigan Borough (43 640).

To help tackle the problem, ministers should commit an additional £2.5bn (€2.8bn; $3.3bn) a year for general practice by 2020-21 as part of the forthcoming long term plan for the NHS, the college said. This would support existing pledges including boosting the number of GPs by 5000, it added.

Alongside this, it said schemes such as the GP Career Plus scheme—initiated as part of the GP Forward View in England—had had some positive impact, but needed to be expanded across the UK to boost retention.

RCGP chair Helen Stokes-Lampard said the figures painted “an extremely bleak picture” that needed remedying urgently.

She said, “Many GPs are bringing forward their retirement plans because the pressures they are working under are untenable.

“If these GPs do leave, and these practices do close, it will have a catastrophic impact on our profession and the patient care we are able to provide. We have more GPs in training than ever before, but if we have more GPs leaving than entering the profession, we’re fighting a losing battle.

“Decision makers need to think long and hard about how we can retain the GP workforce, and the forthcoming long term plan for the NHS is the ideal opportunity to do so.”

A spokesperson for NHS England said, “These forecasts only stack up if you presume no new doctors or health professionals will start work in general practice in the future. The NHS is spending an extra £2.4bn on general practice by 2020 and training more GPs than ever before.”

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