Doctors are warning that the loss of rural GP practices will put patients at risk after a North Yorkshire medical practice shut its doors and left 1,600 people needing a new GP.

Since 2015, in England 1,474 independent community GP practices have closed or merged (as of June 26), resulting in just 6,149 practices remaining. In that same period, the number of full-time equivalent GPs has decreased by 356 – set against a backdrop of increasing patient demand.

Reeth Medical Centre in North Yorkshire closed in May this year when its GP partner retired after 18 years of service to his community. Subsequently, the Integrated Care Board (ICB) – the NHS organisation which plans and manages healthcare services in the region – was unable to find a replacement doctor to keep the practice open. The ICB proposed that its 1,600 patients would be reallocated to neighbouring surgeries. This included the Central Dales Practice, which is based 14 miles away.

Around 10 million people live in rural settlements in England, and a fifth of GPs work in predominantly rural areas. Patients in rural areas can live many miles away from their GP surgeries, which can make care for elderly patients and those with complex needs difficult. Rural practices struggle to recruit and retain GPs, with the closure of local facilities and services, such as schools, banks and post offices, making rural areas less attractive places to live and work. Average house prices in Reeth are also higher than the rest of the country, at £381,242 compared to £271,000.

Speaking about the loss of rural practices, Dr Jonathan Pain, the lead partner at Central Dales, which has now set up a branch surgery at the former Reeth site, said:

“The closure of one local practice has a knock-on impact on another. We didn’t have the space or staff to cope with 1,600 extra patients without additional help from the ICB. The Reeth practice is miles away and local public transport isn’t fit for purpose, so that left many patients stuck.

"We were already one GP down and it is becoming harder to recruit, with local amenities and services decimated it’s not as attractive a job as it once was, so it was a stretch to take on so many people. Working in rural general practice does mean being isolated both professionally and geographically and it seems this is another huge factor putting people off. For doctors who have spent their careers in busy urban practices, moving to a setting where the nearest colleague is based at a branch surgery more than 10 miles away can be a daunting and overwhelming adjustment.

"It was a scramble to fix this problem and we’ve now set up the branch surgery, which can only be a temporary fix until something more permanent can be sorted. Proper planning must be in place to prevent this from happening again, not just for doctors who are overstretched, but for patients who rely on their GP being close by, to receive the care they desperately need.”

Doctors have said that rural practices need better protection. Dr Brian McGregor, North Yorkshire member of the BMA’s GPs committee, who was also involved in the process at Reeth, said:

“Losing a GP is a crisis for patients in rural areas. Locals here tend to be older, or have more complex health needs, and may struggle to travel further afield for their care. Sadly, the closure of Reeth’s surgery is not an isolated incident as over the last decade we’ve lost thousands of GP partners across the country. The relationship between patients and their traditional family doctor is becoming a thing of the past.  

“The closures of nearby health services have shifted the burden on to GPs, stretching their capacity to meet an unmanageable demand, but the system was not designed with rural practices in mind, and they don’t receive the same amount of funding as practices in urban areas to cope with their unique pressures. The proposed neighbourhood model needs to account for rural practices and their patients where geographic distances are much greater for both patient and providers. Practices in rural areas must receive the funding they need to allow them to employ a sufficient number of GPs, so potential closures are prevented, and patients can receive the care they need, wherever they might live.”

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Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.