The closure of GP practices has hit record levels, forcing more than a quarter of a million patients to change surgery, data suggests.
Some 265,000 patients had to change their practice last year - a 150% increase on 2014 figures and a 15% increase on 2015, according to data collected by Pulse magazine under the Freedom of Information Act.
The figures, most of which were provided by NHS England, showed that 57 practices closed completely last year.
A further 34 closed due to the merger of practices.
Some areas were particularly hit, with Brighton seeing seven practices close in the past two years, Pulse said.
Four of these closures meant 9,000 patients had to find a new surgery.
Last year, NHS England announced a £500 million "turnaround package'" to help struggling surgeries, including those at risk of closure.
Dr Chaand Nagpaul, chairman of the British Medical Association's GP committee, told Pulse: 'We know the money, targeted in the right way, for the most severely affected practices, can make a difference.
"The tragedy is CCGs (Clinical Commissioning Groups) have not delivered their part in making the resource available. Many practices that should have received support have had none to date. That's been a failing of local delivery."
Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: "GP practices are the lifeblood of our local communities so the complete closure of any practice will always be a last resort when all other options have proved unworkable.
"Unfortunately, too many practices are being forced to close because GPs and their teams can no longer cope with ever-growing patient demand without the necessary funding and workforce to deal with it."
She said some practices choose to merge "in order to pool their resources to provide additional services or better appointment access, which is in the best interests of patients."
She said practices must be able to access NHS England funding to keep afloat "without having to wade through convoluted red tape".
An NHS England spokesman said: "All NHS patients wanting to register with a GP practice are guaranteed to be able to do so and we have increased investment in general practice by £1 billion in two years in order to improve services and boost GP numbers.
"These figures as presented don't reflect the full picture as they include patients whose records automatically transfer after a merger and therefore don't have to change practice.
"As part of our plans to improve general practice services and boost the workforce, many practices are choosing to merge in order to offer patients a much greater range of services."
Shadow health secretary, Jonathan Ashworth, said: "Given the crisis in hospitals we've seen, we need to be taking pressure off of hospitals.
"That means doing much more to protect GP services. With Labour, general practice will be at the heart of making the English NHS more focused on care closer to home.
"Tory ministers need to take urgent action to address this spike in GP practice closures and explain what they will do to make sure patients can easily and safely access the GP services they need."