Closing your patient list in Scotland

This guidance is to help GPs decide whether they should formally apply to close their practice list, or if informal list measures would be better suited to their situation.

Location: Scotland
Audience: GPs Practice managers
Updated: Monday 7 September 2020
GP practice article illustration

Formal list closure

GMS practices can apply formally to close the practice list if their workload is impacting their ability to provide safe care for their registered patients.

Practices that do not wish to have patients assigned to their list by their NHS board must go through the list closure procedures set out in the regulations (paragraphs 26-28 of Part 2 of Schedule 6).

If your application is approved

  • The practice’s list is officially closed to new patients.
  • The closure period will be either for a maximum of one year, or if a range was specified in the closure notice, until an earlier point in time when the number of patients falls below the bottom figure of the range.
  • The only patient registrations that practice may accept are those from immediate family members of existing patients.

 

Further considerations

Before applying for formal closure, the following should be taken into account:

  1. Is there an opportunity to negotiate with the NHS board team for staffing support with other services?
  2. There will be a responsibility on both the practice and the NHS board to ensure that all options other than closure have been considered.
  3. Document what options you have considered in trying to address the problems and any outcomes.
  4. Discuss your practice's problems at the earliest opportunity with your LMC who will provide you with support in line with the rules and regulations.
  5. Consider the possible impact on neighbouring practices and any help they can provide.
  6. Meet neighbouring practices with LMC representation to discuss your practice's problems.
  7. Request a meeting with the NHS board and let them know you will be with an LMC representative.
  8. Discuss with your patient participation group to explain how and why you have come to this decision and to listen to any suggestions they may have.

 

Informal list closure

A practice can informally decide not to register new patients, provided it is not for discriminatory reasons. Considerations you should make when doing this are below.

However, the formal closure route makes it far more difficult for the NHS board to be able to add any new patients to your list.

Support from the NHS board

Should a practice be unable to accept patients routinely, a discussion between the practice and the NHS board could take place. This could involve, for example, additional support being provided by the NHS board and would normally lead to an application for formal closure.

Declaring your intention

You do not need to make an official declaration. However, the regulations state you must provide patients with a written notice. It is good practice to put up notices, provide patient leaflets and post on your website that you are not accepting any new registrations, and explain why.

Justifying your decision

The NHS board may still assign patients to your list. They may ask you to justify the decision not to register a patient. 

A written acceptance policy will enable practices to refute any suggestion of improper rejection of applications.

Referring to your list as 'closed'

Practices should not refer to their list as ‘closed’ when it has not been formally closed and should only state that they cannot take on further patients at present.