An update on Closed Books in general practice in Aotearoa New Zealand

Introduction People are precluded from enrolling in primary health care at a general practice if it has 'Closed Books'. This creates barriers to accessing health care. Aim To examine which Health Districts had the greatest number and proportion of general practices with Closed Books and how this has changed since 2022. Methods Maps were used to display the distribution of Closed Books general practices and tables were used to compare changes in Health Districts over time. Results There were 373 (36%) general practices that had Closed Books in September 2024. Canterbury (n = 56), Southern (37) and Northland (32) Health Districts had the greatest number of Closed Books general practices, while Hutt Valley (73%), Lakes (70%) and Wairarapa (67%) Health Districts had the greatest percentage of general practices with Closed Books. Discussion The problem of Closed Books was felt across the country but has a larger impact in the middle-lower North Island and an increase in impact in Northland and the lower South Island. Improvements have been seen in the worst hit areas since 2022 but, overall, the percentage of general practices with Closed Books has not improved.