The referendum for all GPs in Northern Ireland has closed
99.6% of GPs voted to REJECT the offer.
We will continue to engage with the Department of Health to find a resolution.
Following months of negotiations with the Department of Health / SPPG a contractual offer along with access proposals have been shared with GPs in Northern Ireland. .
Background and context
When we began negotiations for the 2025-2026 contract, the negotiating team made it clear from the first meeting there were several ‘key asks’ in terms of what we believed was needed from this year’s contract agreement to stabilise and secure the future of general practice in Northern Ireland:
- An increase of £80million into core funding for general practice
- A fully funded indemnity solution for all GPs in Northern Ireland
- Funding to cover the increased costs of Employers National Insurance Contributions.
All of these are essential for GPs who are facing rising costs and increasing demand, putting additional pressure on an already stressed workforce. GPs have faced relentless criticism that patients are unable to see their GP or get an appointment, despite the Department’s own data showing this is not the case; 200,000 appointments are delivered every week, that is 10% of the population seeing their GP every week. Annually in Northern Ireland there are just over 750,000 attendances at A&E, so it is clear the huge volume of work GPs are undertaking for a fraction of the health budget.
An increase of £80 million into core funding represents about 1% of the overall health budget in Northern Ireland. It will help stabilise general practice but will also show that the Department of Health values the contribution of general practitioners. Currently general practice receives only 5.4% of the health budget despite the huge workload GPs undertake.
As you will be aware the roll out of indemnity did not happen as we envisaged in 2024/25, therefore for this year's negotiations we were clear that any indemnity solution needed to fully cover the costs all GPs face for indemnity.
Unfortunately, the current proposals from the Department do not in our opinion meet these key asks. We now want to get the views of all GPs and therefore we are asking you to tell us whether or not you view what is being offered as acceptable.
What is being offered?
| Our asks | DOH offer |
|---|---|
| £80m invested into core GMS to stabilise general practice | £1 million additional investment in core GMS, tied to unagreed access changes |
| A fully funded indemnity solution for all GPs | Only £5 million for indemnity, paid on the basis of capitation, covering only partners/principals |
| Full funding to cover the cost of increased NIC charges | Minister promised £3.5 million for NIC costs - our ask is that the actual costs to practices are fully covered |
| Return of £5.6 million into the baseline core funding from 2023/24 | Agreed in principle, subject to further negotiation on exact distribution |
| Department of Health Ask | Our response |
|---|---|
| Changes to GP access - outlined through 17 proposals in access paper, issued 30 April 2025 | Committed to considering each of the proposals through an established working group in 2025/26 to ensure workability and safety |
In addition to what we see as an extremely poor response to our asks, in February the Department asked us to consider an initial paper on “Access to GP”. This contained 18 actions the Department feel will improve access to GP.
It quickly became apparent that this paper was a red line for the Department. The negotiating team committed to participating with Department in a working group that would consider each of the 18 proposed actions, despite the lack of rationale from the Department on why they had developed these actions or presenting any evidence that they would improve access. This was not enough for the Department, who want some of the actions implemented before they will agree a final contract offer. A revised version of this paper has now been drafted with 17 proposals.
We will not commit general practice to actions that have not been thoroughly discussed, and appropriately resourced.
Next steps
GPs have now rejected the offer and have indicated that they are willing to take collective action if an acceptable offer is not received. BMA will continue to engage and consult with GPs as we move forward. We will continue to meet with our political representatives to encourage them to elate this seriousness of this situation to the Minister.