Experts warn of impending crisis as up to 140 practices in the capital could shut with the remaining ones struggling to cope with the influx of ‘refugee patients’

Scores of GP surgeries in London are under threat of closure, potentially displacing hundreds of thousands of “refugee patients”, because of a growing shortage of family doctors, research shows.

Up to 140 of the capital’s 1,400 GP practices could shut over the next three years, leaving fewer surgeries looking after increasing numbers of patients, according to a survey by Londonwide local medical committees.

The closures are stark fresh evidence of the escalating shrinkage of GP practices across England as a whole. NHS figures show that 656 surgeries have been merged, taken over or closed completely since 2010.

The trend has sparked concern that patients will lose their longstanding relationships with their GP and have to find a new surgery and travel further for an appointment.

Of 431 surgeries polled, 43 (10%) said they were considering handing back their contract to NHS England within the next three years because a GP colleague was due to retire during that time. If the same proportion was replicated across the 909 other surgeries that did not respond, almost 140 could shut.

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In all, 302 of the 431 practices said that at least one of their doctors is due to retire by 2018 and 53% are already trying to recruit a GP or practice nurse.

Increasing workload, financial problems, the growing complexity of patients’ illnesses and the pressure to work ever longer hours are also prompting more GPs to retire. That raises serious doubt about David Cameron’s key post-election pledges to hire 5,000 more family doctors and let patients see a GP between 8am and 8pm seven days a week by 2020.

“This is a three-year timebomb. In the next three years London could lose as many as 10% of its GP practices. For patients that is an unsustainable rate of loss,” said Michelle Drage, chief executive of Londonwide LMCs – which represents more than 7,000 GPs and 1,300 surgeries in 27 of London’s 32 boroughs.

If all 43 practices considering terminating their contract ended up doing so, an estimated 337,979 patients would lose their GP.

“Patients will definitely miss these surgeries when they go. They are at risk of losing their GP services and relationships with family doctors built up over many decades in some cases. In London there’s going to be fewer and fewer surgeries trying to cope with more and more patients at a time when the population is growing,” said Drage.

“Patients will get new GPs who they have to start to get to know, and they’ll see practices that are even more stretched than they already are. And there will be added stress on GPs and practice nurses who have to deal with patients who have been displaced – refugee patients. They end up moving around local surgeries and having to tell their stories all over again because a practice they have been with for many years has suddenly shut because the doctor has gone.”

The Royal College of GPs, meanwhile, warned that the closures could affect millions of patients, with some denied a GP of their own altogether.

“It is shocking that we have reached a situation where so many GP practices – the lifeblood of local communities – have closed or are under threat of closure,” said Maureen Baker, the RCGP chair. “Unless drastic action is taken, thousands, if not millions, of patients could be forced to travel miles to their nearest GP practice or be left stranded with no family doctor at all.”

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Surgeries faced with an influx when a nearby practice closes may struggle to cope, warned Baker. “We know that in many areas practices are closing because there are not enough GPs to run them and this can cause a domino effect of piling the pressure on neighbouring surgeries, particularly in remote and rural areas and areas of high deprivation.”

In London, 117 surgeries closed while only 40 opened between January 2010 and the end of August 2014. Another 18 shut and just one opened in the nine months between last August and the end of May this year, according to data from the NHS’s Health and Social Care Information Centre.

Closures, which include mergers and new operators taking over practices where the GPs have given it up, have far outstripped the creation of new premises each year since 2011.

NHS England and the Department of Health refused to respond directly to the escalating closures and impact on patients’ access to GP services. A spokeswoman said: “All NHS patients wanting to register with a GP practice are guaranteed to be able to do so. As GPs move to create wider networks of care, like the RCGP, we fully expect more practices to come together to offer a wider range of services. However there is also no doubt that we also need to increase the investment in general practice, boost GP numbers and expand team working.”

The DH reiterated that health secretary Jeremy Hunt’s “new deal for GPs” would see extra investment in general practice during this parliament.

“But in exchange we need doctors to improve continuity of care and surgeries to offer seven-day appointments,” the spokeswoman added. “We recognise that GPs are already working hard, so we will increase capacity by 5,000 GPs over the next five years, including helping with flexible working.”

Baker wants George Osborne, the chancellor, to establish a stabilisation fund to help surgeries at greatest risk of closure because of financial or staffing problems and ministers to pledge that no surgery will close because it lacks resources.