Doctors in Folkestone have warned patient safety is at risk because of a GP shortage that has seen one surgery close this week, with seven other practices telling officials they are too full to take any more patients.
The Folkestone East surgery closed on Tuesday with more than 25% of its 4,700 patients, many of them extremely vulnerable, yet to be allocated a place with an alternative doctor.
Local GPs say the Kent town has 16 fewer GPs than it needs, and warn remaining surgeries are "on their knees".
The situation has left doctors in revolt against the local health authority. Earlier this year, GPs at seven practices told the South Kent Coast Clinical Commissioning Group (CCG) that they want to close their lists to new patients.
The CCG, which has to give permission, refused, and instead effectively forced surgeries to accept new patients through a system of allocation, where places are determined centrally.
The surgery says 1,900 patients have still not been found places, while the CCG says it is only 1,300.
Doctors say the GP shortage is compromising the level of care they can provide and that the CCG refused to accept that many patients, including some with cancer, mental health conditions and substance dependencies, should be prioritised.
The British Medical Association (BMA) told Sky News the position in Folkestone reflects an acute shortage of doctors in primary care across the country.
The Folkestone East surgery closed following the retirement of two GPs and a third leaving the area. Despite trying to recruit replacements in the UK and abroad for more than a year, the practice did not have a single application.
Dr Vanessa Goodall, a partner at the practice, said it left them with no choice but to close.
"We tried [to recruit] for over a year both in this country and abroad, and didn't get a single applicant. Not one," she said.
"Only a couple of years ago there would have been 20 plus replies to that advertisement and we would have to run a couple of days of interviews. There are just no GPs available now, everyone is working to their maximum capacity."
Dr Goodall said patients had been upset by the closure and care may suffer as patients lose their connection with their family doctor.
She added: "We've already seen the impact, the level of stress and distress we've seen in the last six months I never want to see again. Many of our patients are fearful, really fearful for the future.
"I personally feel that they are going to practices with experienced GPs, but those practices are already full and bulging at the seams. To continue to provide care to 500 or 1,000 new patients overnight, who they've never met, is a tall ask."
To be allocated a new doctor, patients had to fill in and return a nine-page form that is processed under contract by Capita at offices in Preston. They are then assigned a doctor and have to visit the surgery to register.
South Kent Coast CCG said 1,300 people are yet to return the form and will receive reminders. Dr Goodall said the surgery asked the CCG to automatically allocate all 4,700 patients but it refused.
Doctors and the CCG have also disagreed about the definition of vulnerable patients. The surgery said 2,320 patients should be prioritised, but the CCG calculated that only 1,143 qualified.
The surgery said those left off their list included those with diabetes, cancer, HIV, heroin and cocaine addiction, and some who have made recent suicide attempts.
Dr Richard Vautrey, chairman of the BMA's GPs committee, said: "The pressures that GP practices in Folkestone are a reflection of a huge workload pressures that practices are experiencing right around the country.
"We're seeing reports of practices under pressure right around the country and that's because of a decade of underfunding, a difficulty recruiting new GPs and many practices feeling that the service that they are offering to patients is at risk of not being safe enough."
In a statement, South Kent Coast CCG said: "The vast majority of Folkestone East patients have been successfully allocated to another local GP practice. We would encourage any remaining patients to complete and return their allocation form as soon as possible so that we can assign them to a new surgery."
A Department of Health spokesperson said: "We understand the pressures GPs face as demand increases and our population ages – that's why we are investing an extra £2.4bn in GP surgeries over the next three years.
"But it is imperative that communities have access to their local surgeries, and we would urge GPs to consider the impact closing their lists would have on the wellbeing of their patients."