Nearly 600 GP practices have closed in the last five years, data seen by HSJ reveals.
However, patient list sizes have steadily risen over the same period, which suggests a shift towards larger scale providers.
Between 2010-11 and 2014-15, 599 GP practices closed, according to Health and Social Care Information Centre figures. Ninety-four practices opened during this time (see graph below).
Ninety-one practices closed in 2010-11, rising to 115 in 2011-12 and 145 in 2012-13. The figure fell to 99 in 2013-14, but jumped to 149 practice closures last year.
The numbers include practices that have merged or been taken over, and are therefore still providing services. There has been a push by policymakers to scale up primary care, and it is a feature of the new models of care outlined in the NHS Five Year Forward View.
The average number of registered patients per practice has steadily increased in the past five years, from 6,610 in 2010 to 7,171 in 2014, according to the information centre (see table below).
Average list size, 2010-2014
|Year||Average practice list size|
Richard Vautrey, deputy chair of the British Medical Association’s GP committee, told HSJ the figures “demonstrate the trend towards bigger practices which has been a steady pattern over recent years”.
However, he said: “It is likely that this could be accelerating as practices which were previously sustainable are becoming unsustainable because of funding cuts, rising workload and difficulties with GP and nurse recruitment.”
Dr Vautrey predicted there would be a “significant difference from the steady state situation” in the current financial year, as “all of these pressures are coming to bear”.
He said there were “significant changes going on around the country, with practices actively considering mergers, which they weren’t doing before, and with a number of small practices and with older GPs deciding that enough is enough and closing as a result of the various pressures they’re facing”.
He said he thought 2013-14, when fewer practices closed, was a “blip”.
“The only thing that could potentially account for it… would be that [reviews into GP practice funding] hadn’t yet started at that point, and so maybe some practices were waiting to see what the approach of NHS England would be before making any decisions about closing or merging with other organisations,” he said.