The future of a Plymouth GP surgery which serves around 10,000 people has been thrown into doubt after the provider handed back its contract.
Partners at the Mannamead Surgery have chosen to give their contract back to the Devon Clinical Commissioning Group (CCG) - who took over from NHS England at the start of this month - following a series of changes at the practice.
Patients are being told they should still attend the surgery as normal and all services will continue for now. Talks are ongoing about a new provider.
It is the latest blow in the city's continuing primary care crisis.
Since 2016 a number of doctors have handed back their contracts to run surgeries.
This has led to a number closing down and others being run temporarily by an offshoot of the out-of-hours doctors service Devon Docs.
The largest of the practices to had back its contract was Ocean Health, which ran a surgery at Sterling Road and two others at Chard Road and Collings Park.
They covered 22,000 patients in Plymouth. All of these patients and some 12,000 more are currently being looked after on a temporary basis - and as yet NHS England has not been able to secure anyone to permanently take them on.
Other doctors practices that closed transferred their patients on to other surgeries.