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Should GP practices be left to fail?

An NHS official has suggested that vulnerable practices could be left to wither by the system.

NHS England has denied this is the case. However, NHS England is, as we know, obsessed with what it calls 'working at scale' – bigger is best.

Is the NHS official concerned communicating government policy, or explaining the consequences of it? What does the evidence tell us?

From my own experience, I have seen no investment in surgeries with hardly any new premises developments – and where they have happened GPs have not always received any additional rent reimbursement. Generally, it is the larger practices that can take the risk and develop and bring in non-NHS services and finance.

I have seen increased bureaucracy with no concern for the effect on practices.

I visited a client recently who was facing major cost and disruption after being told by infection control that their old woodchip wallpaper (among other things) was a health hazard. Despite some extensive Googling I can’t find any evidence of actual health problems caused by woodchip wallpaper. Making good demands like this is a disproportionately heavy expense for smaller practice.

I have seen many practices close and their lists dispersed – with no help for other practices having to take on patients. I have also seen struggling practices being denied the ability to close their lists when they try to absorb the workload. It is more difficult for smaller practices with fewer GPs to cope with this extra work.

Most recently we have all seen the hopeless centralisation of NHS support services with the numerous mistakes and practices unable to get hold of anyone to sort them out.

I have been conducting my own campaign with my MP and I repeatedly receive assurances about all the money that is going into general practice.

For me, my version of the truth is that general practice is underfunded and undervalued by NHS England. Whether that is by design or a consequence of poor decision making is open to question, but the consequences are going to affect the vulnerable practices first.

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