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Vulnerable practices must be supported, not closed

'Unacceptable' delays in delivering resilience funds could leave communities without a GP

Louise Prime

Thursday, 13 October 2016

Vulnerable practices that are facing closure because of delays in delivering crucial funding from NHS England’s resilience programme must not be allowed to “wither away on the vine”, doctors’ leaders asserted this morning. They said communities rely on these practices, many of which were previously performing well. New research has also revealed that four out of five GPs in Wales are worried about the sustainability of their practice, almost half would not recommend a career in general practice, and more than a quarter are considering a career change.

A document leaked to Pulse and the BBC revealed that NHS England plans to allow some vulnerable GP practices in England to fail and close. GPs’ leaders have responded furiously today, particularly as there have been delays in delivering funding to practices in need.

Chair of the BMA GP committee Dr Richard Vautrey pointed out that many of the now ‘vulnerable’ practices were previously performing well and valued by their patients, until hit by spiralling workload and recruitment problems beyond their control. He said: “The entire basis for the practice resilience scheme was to provide immediate support to the hundreds of GP practices across England which are facing closure because of rising demand, staff shortages and falling budgets. The BMA lobbied intensely and successfully for this funding because there is a real prospect that patients in some areas will be left without access to local GP care.”

He said the apparent delays in delivering this crucial funding, and some managers’ belief that surgeries should be allowed to close, are unacceptable. And he warned: “These services are not trivial: they provide vital care to families, older people and the vulnerable as the lynchpin of the NHS in the community. The government needs to deliver this funding immediately and deter a mind-set amongst managers that some GP practices can be allowed to disappear.”

The Royal College of GPs pointed out that practices are the heart of their communities, relied on by patients. It added that being vulnerable does not meant that a practice is either providing poor care or is resistant to change. College chair Dr Maureen Baker said: “Practices can be vulnerable for many different reasons, such as problems in recruiting, financial pressures and rocketing patient demand against the backdrop of a decade of dwindling resource.”

She urged swift delivery of resilience funding to those practices most at risk of closure, and went on: “Far from leaving them to ‘wither on the vine’, NHS England’s resilience programme ought to be identifying practices that are at risk of closure and providing them with immediate practical assistance. If this is not happening it is very concerning and we will be raising this with NHS England.”

She warned: “If general practice is allowed to buckle, it will plunge the entire NHS into jeopardy. We urge NHS Chief Executive Simon Stevens to make clear that any strategy to stop support for general practices is contrary to the GP Forward View and totally unacceptable.”

BMA Cymru Wales’ General Practitioner Committee (GPCW) today launched its urgent prescription for general practice in Wales, a campaign to tackle the unprecedented pressures facing the profession. Its latest survey revealed that:

  • 82.1% are worried about the sustainability of their practice.
  • 61.4% do not have a good work—life balance.
  • 74.8% said the health of their practice staff had already been impacted negatively by workload.
  • 49.6% would not recommend a career in general practice.
  • 27.1 % are considering a career change and 13.8% are considering moving abroad.

GPCW chair Dr Charlotte Jones said: “I have grave concerns for the future of general practice if the significant and worsening challenges are not urgently and meaningfully addressed at a national level. The Welsh Government must recognise this and take action.

“There is a significant gap between the demand placed upon general practice and its capacity. … GPs continue to remain committed to the profession but for it to turn around, they need the tools, resources and support of Welsh Government.”

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