Half of small GP surgeries have shut in a decade with patients sent to ‘soulless’ alternatives

Rise of the mega-practices: Half of our smaller GP surgeries have shut in less than a decade with patients having to use ‘soulless’ alternatives, data shows

  • More and more NHS patients forced to travel to mega-practices far from home
  • Small surgeries preferred due to ‘continuity of care’, cutting risk of early death
  • ‘We don’t have enough GPs to meet demand’, according to top BMA doctor
  • Cancer patients waiting twice as long as they should higher than in pandemic

Half of England’s small GP surgeries have closed in less than a decade – with more patients forced to travel to ‘soulless’ mega-practices, figures show.

Health leaders warned the move threatens the treasured doctor-patient relationship as patients are less likely to see the same medic each time.

The number of practices has fallen from 7,816 to 6,522 since the 2015 general election – pushing the average list size up from 7,294 patients to 9,441.

Small surgeries are preferred as they provide care continuity, cutting early deaths (file image)

GP practices with fewer than 5,000 patients have halved over that period, while those with more than 20,000 patients have more than tripled.

Some have been shut completely, leaving patients with no option but to travel, while others have merged with another surgery.

Small GP practices are among the most popular with patients, surveys show.

They are also associated with better continuity of care, which has been shown to cut the risk of premature death and hospitalisation.

GPs last night warned the rapid shift towards ‘working at scale’ has left the profession at risk of ‘losing its soul’. 

Dr Lizzie Toberty, of Doctors’ Association UK, told GP Online: ‘Smaller practices have historically been very successful with this and if we lose continuity we will lose the soul of general practice.

‘Our worry is there is a huge push to work at scale, which loses sight of what patients really value in their care.’

Cancer patients waiting twice as long as expected is now higher than during Covid (file image)

Cancer patients waiting twice as long as expected is now higher than during Covid (file image)

The NHS listed 7,816 GP practices in April 2015. Some 1,375 of these are no longer listed and only 80 new ones have been established.

The average list size of practices lost since April 2015 is 4,607 – showing that mergers and closures have disproportionately affected smaller GP practices. 

Yet practices with more than 2,000 patients skyrocketed from 86 in 2015 to 317 in 2022.

Dr Kieran Sharrock, of the British Medical Association’s GPs Committee, said: ‘We don’t have enough GPs to meet the demand and for those who are still here, many are exhausted and considering leaving too.’

Professor Martin Marshall, chairman of the Royal College of GPs, said: ‘The real issue is about having enough GPs… that is why the Government urgently needs to deliver on its promise of 6,000 extra GPs and 26,000 additional members of the practice team by 2024.’

The number of cancer patients waiting almost twice as long as they should to start treatment is worse than at any point in the pandemic.

Of the 15,178 people having their first treatment in February, 10.7 per cent had waited more than 104 days after referral, the Health Service Journal revealed.

The target is for 85 per cent to start within 62 days. 

An NHS spokesman said: ‘The NHS is taking action to reduce the Covid-19 backlog.’

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