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Every practice in the UK is threatened by one of a raft of government policies that will bite this year, GP can reveal.

As well as the cut to the correction factor leaving most practice incomes frozen, policies including polyclinics, APMS contracts and changes to dispensing rules mean that every practice in England will face extra pressure or be forced to close altogether.

The cuts and changes are happening against a background of rising costs which means that practice funds at Scottish, Welsh and Northern Irish practices will be under further pressure from an already lower base.

GPC chairman Dr Laurence Buckman said that GPs were facing more threats to practice survival than any time since the 1960s, when practices were so cash strapped and understaffed that GPs resigned en masse in undated letters.

'What happened in the sixties was accidental,' said Dr Buckman. 'This appears to be more of an organised threat.'

Nick Goodwin, senior fellow at the King's Fund think tank, said that prime minister Gordon Brown's attacks on GPs could be paving the way for 'something new and shiny that they say is better for you'.

'The days of setting up a practice and having a job for life are over,' he said.

Analysis shows that the future of urban, suburban and rural practices is likely to suffer under very different policies.

In major cities, plans to reconfigure primary care around polyclinics will redirect resources from existing practices. A Conservative party analysis suggests that plans for 68 polyclinics in London would mean the closure of more than 1,000 practices.

Practices in suburban and commuter areas could also lose patients to private providers, as companies such as Virgin and Boots provide more accessible services.

Inner-city practices are unlikely to close, because the government is keen to tackle recruitment in under-doctored areas. But competition from new APMS practices could mean shrinking lists and incomes.

Meanwhile, plans outlined in the recent pharmacy White Paper mean that more than 80 per cent of the 1,170 dispensing practices in England could lose as much as half of their income.

Compounding these problems, 90 per cent of practices rely on the MPIG, so will receive no income rise after this year's Doctors' and Dentists' Review Body report.

jonn.elledge@haymarket.com