General practitioner Patient and public Practice manager Northern Ireland

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General practice is in crisis

BMA Northern Ireland is calling on the government to address the escalating crisis in general practice.

Our recent report highlights the increasing pressures GPs in Northern Ireland are facing, especially in small rural practices where there is a high risk of closure.

 

What we are calling for

Funding

  • A public commitment from the new minister to invest incremental recurrent funding in general practice at a minimum of 10% of the health budget and to rebalance health resources to where care is delivered. Transforming Your Care, envisaged care being delivered closer to home with the expected shift in resources to accompany this. 
  • The provision of an immediate stabilisation fund for general practice to provide emergency support to vulnerable practices at risk of collapse or where safe patient care is compromised such as out-of-hours.

 

GP taskforce

  • Similar to the NIGPC Rescue Plan Group, the department must establish a task-force to provide support to vulnerable or at risk practices which could include the provision of management resources, clinical input, proactive support that can be called in at short notice. This needs to be developed in liaison with the Local Medical Committees (LMCs).

 

Workloads

  • It is vital that a national standard is set for a maximum number of patients that GPs, nurses and other primary care professionals can reasonably care for during a working day to maintain the delivery of safe and high quality care.
  • GP Federations are in a position, if properly supported and funded, to provide locality hubs to which practices can refer urgent patients when they have reached the threshold for safe care on any given day.
  • Establish a list of services that are not included in the core GMS contract which practices can chose if they wish to provide.
  • Develop guidance for ensuring that secondary care work is not passed onto GP practices.
  • Review and reduce the bureaucracy on general practice in areas such as QOF and appraisals.
  • Ensure information technology is fit-for-purpose and resourced. For example online/phone triage / AskMyGP.

 

Workforce

  • We know that there are not enough GPs and we need a clear and credible plan to recruit and train more GPs for Northern Ireland.
  • Immediate resources to fund an expanded and comprehensive primary care team to reduce and relieve GPs workload, including mental health practitioners, health visitors, advance nurse practitioners, physiotherapists and physician associates.
  • Increase opportunities for patients to directly access services such as specialist nurses or physiotherapists to reduce the GP first point of contact.
  • Reduce the bureaucratic burdens of the GP returner scheme.
  • Invest in GP out-of-hours service to enable an expanded and sustainable clinical workforce, addressing issues such as indemnity costs.