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BMA writes to warn patients GPs may have to turn them away over winter

GP leaders have written an open letter to patients saying practices may be forced to 'cut opening hours', 'stop routine services' or 'send patients directly to hospital' over the next months.

BMA Northern Ireland's stark warning for winter comes as the UK Government said today that NI public services cannot be sustained much longer amidst ongoing political stalemate.

GPC NI chair Dr Tom Black said there had been ‘abject failure’ of politicians to address the unprecedented pressure facing GPs and no health minister for the whole of 2017.

He said in the letter to patients: 'Over the winter months GPs and their staff will do their best to maintain vital services for the most vulnerable patients, however it is only fair to warn you that some practices may have to cut their opening hours, stop routine services, deal with cases over the phone or send patients directly to hospital in order to manage workload.’

He asked patients to get their flu jab, deal with minor illness at home and seek pharmacist advice in the first instance.

The letter added: ‘This crisis in GP services has been caused by a lack of funding, a huge increase in workload and a failure to attract young doctors into general practices. 

‘The average GP is now responsible for the care of 2,000 patients.’

The GP crisis in Northern Ireland has been greatly exacerbated by the political limbo with no way to implement an agreed plan to rescue general practice.

There was no new contract for 2017/18 with the previous year’s deal rolled over and BMA figures show there are now just 336 GP practices - down from 365 in 2005 - with the expectation of further closures and mergers.  

And yesterday Northern Ireland secretary James Brokenshire told MPs that ‘time is running out’ to break the deadlock with no formal budget and the country on a path to losing autonomy.

In a written statement to Parliament, Mr Brokenshire said there had been no devolved government for 10 months despite efforts to bring the parties together.

‘The outlook for an imminent resolution is not positive. Time is running out. And without an agreement, we are on a glide path to increasing intervention by the UK Government.’

He stressed a budget must be in place no later than the end of November and if agreement on finances cannot be reached by 30 October, the only option would be for Westminster to intervene.

‘My strong preference is for a restored Executive in Northern Ireland to take forward its own budget.

‘Without an Executive, though, it would be grossly remiss for the UK Government not to step in and take action to ensure the continued funding of critical services in Northern Ireland.’

It comes as the UK BMA's Annual General Meeting voted overwhelmingly in favour of general practice adopting a hospital-style model of declaring ‘black alerts’ when workload or workforce issues mean they are not safe to deliver care.

The motion, agreed in June, committed the BMA and GPC to establish a black alert reporting system ‘with or without’ the Government’s cooperation.

Conversely, as Pulse exclusively revealed two weeks ago, NHS England urgent care leads had considered piloting a model whereby patients could not turn up to A&E without a GP referral.

The letter in full

OPEN LETTER TO THE PUBLIC OF N IRELAND

Copied to newspaper editors

It is well known that GP services across Northern Ireland are facing unprecedented pressure in terms of increased workload and a severe shortage of doctors. The abject failure of local politicians to address these issues has exacerbated an already critical situation.

Over the winter months GPs and their staff will do their best to maintain vital services for the most vulnerable patients, however it is only fair to warn you that some practices may have to cut their opening hours, stop routine services, deal with cases over the phone or send patients directly to hospital in order to manage workload.

To help manage workload we would encourage patients, where possible, to deal with minor illnesses such as sore throats, coughs and colds with treatment at home. Your local pharmacy should be your first point of call for these minor issues.

We would also encourage everyone who is eligible to get their flu vaccine as we expect the influenza epidemic to be severe this winter.

This crisis in GP services has been caused by a lack of funding, a huge increase in workload and a failure to attract young doctors into general practices. The average GP is now responsible for the care of 2,000 patients.

Dr Tom Black

Chair, BMA Northern Ireland’s General Practitioners Committee

Readers' comments (10)

  • DOH will accuse us of breach of contract, with no hesitation, as context matters not to them.

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  • What happened to the threat at the beginning of the year that NI general practice was going to resign itself from the NHS and follow the Republic of Ireland model.

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  • threat but no action, letter but no action, GPs are really naive. Exploit them.

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  • Credit to BMA NI for being frank with patients over there. I am a partner at the practice featured here:

    http://www.pulsetoday.co.uk/clinical/mental-health/patient-death-was-knock-on-effect-from-lack-of-gp-resources-says-coroner/1/20035084.article?PageNo=2&SortOrder=dateadded&PageSize=10#comments

    No-one in England seems to have the balls to directly tell our patients how it really is the way they have done.

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  • I make it absolutely clear to every patient who complains about waiting times it is due to the government's cuts to the health service budget. I encourage them to write to their local MP and provide them with his details.
    I make it clear there is absolutely nothing GPs can do about waiting times.

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  • Rogue1

    Its getting that way over here in England. 2 and half week wait for a routine GP appt, and we have no flu (few colds) but nowhere near winter pressures yet!

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  • Welcome back to the days before the NHS existed. If the allowed budget for the NHS isn't enough and the workforce isn't big enough to provide the expected care then the lifespan of the population could be comprised. If the population doesn't live so long then pensions will be paid for a shorter time and there will be fewer people needing medical care. Sounds like the ultimate in cost efficiency savings to me or am I just getting even more cynical with age?!

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  • I thought over winter ...A+E will be diverting as many as possibly to Gen Practice / OOH... Great... we can let them know ...maybe no room at the inn... Brave new world...Try not to get ill... No wonder indemnity is rocketing

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  • P.s fed up seeing Prof Field whenever menu comes up ...please change... not Jeremy Hunt either....

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  • Why doesnt the RCGP arrange to 'fold' the last practices in the weakest of the areas highlighted and re-alocated them to struggling areas elsewhere..... when we have 5 or 6 regions completely devoid of GPs then this will be news and make a clear mockery of the claims of increased numbers in General practice. If I were RCGP chair I would be inviting overseas recruiters here in droves to plan our mass GPexit, shut down training to new candidates due to lack of GP trainers, and start planning for the implosion of both General Practice and the NHS. I would make every surgery a billboard about how health minister after health minister has lined their own pockets through 'consultancy' work for private medical companies, and the stats for how much the legal profession makes out of suing their NHS, and how many of the politicians hold law degrees.....how they have made it a race to the bottom to drive out valued staff to run down the system to ripen it for privatisation..... and that when they are now forced to go privately to seek any care, it was the conservative government who wanted this...... and welcome the USA style of care..... expensive, over investigation, over treatment, poorer outcomes......and remind voters that THEY allowed it to happen by not challenging their politicians.....I would then arrange to exit the expensive London white elephant and arrange an emergency HQ in lets say birmingham, to continue the run down - a bit like Dunkirk, but from our own home soil to friendlier shores, as we are over-run by the corrupt establishment. You need an effective PR machine to fight for the resources to run a safe service, currently decent hardworking GPs are being slaughtered with more work, higher, risks and dwindling incomes...the RCGP has been extremely inept at this task. Theres an analogy here...'if you think education is expensive try ignorance'......'If you think health care is expensive..try it without Primary Care' I would hammer the stats of our efficiency everywhere, with comparable examples of waste at the bloated ends, bureaucrats pay, pensions, terms and conditions, those in the private sector to allow the public to make a comparison of value. But yet all we hear is a deafening silence from a timid RCGP too afraid to rock the boat.... more interested in self service and self promotion rather than fighting to put in a stable foundation in for their colleagues to work from.....unfortunately the heads of our respective organisations have become part of the establishment. They will not fight for us. They do not actively lead us. Therefore as they are abandoning us, we should abandon them. People should cancel their RCGP subscription. Mass resignations from RCGP might show the college the depth of feeling, collapsing the college might be the first step in recovery. If we threaten the viability of the RCGP this might finally shake up its senior staff into action. They should ballot all its members as to what action it should take.

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