A quarter of practices are now at risk as staff buckle under workload pressures, according to a major new survey.

The findings come from the Royal College of GPs, which found hundreds of GPs and practice managers reporting “fears” that their practice would close. Some 2,600 practice staff took part in a college survey and 90% said workload pressure was why they feared for the future of their practices. 65% said it was also because of a GP partner leaving.

The college said a coming government recovery plan must include properly funded proposals to respond to surges in demand on general practice. It also called for urgent “new and improved” retention schemes to keep doctors working in general practice and for a reduction in box-ticking. It is calling for public education to advise patients how to self-manage illness and when to seek GP help

College chair Professor Kamila Hawthorne said: “It is hard to think of a more challenging time in general practice, too many GPs are now finding their position untenable and are feeling too stretched to guarantee patient safety. I’ve certainly heard of colleagues of mine becoming so stressed during their days of work that they’re developing chest pain and needing to be seen themselves. Many are also needing to take time off, due to stress at work. If you’re seeing 40 to 60 patients a day and making that number of clinical decisions, it is extremely stressful because each one of those clinical decisions is important.

“We are seeing more patients than we’ve ever seen before – and a greater proportion of our patients suffer with multiple chronic medical conditions – we are really busy and getting busier. Yet we have fewer doctors because GPs are leaving the profession due to the intolerable workload and workforce crisis that we’re under. Without general practice, the NHS won’t survive. We see a vast number of the patients that come to the NHS, and we deal with most of what people need from the health service. If we’re not there, secondary care services will just be completely overwhelmed.”