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Independents' Day

Crisis-hit Northern Ireland GPs vote to focus on 'core' workload

Increased use of telephone triage, closing lists to new patients and half-day opening are among a range of measures agreed by GPs in Northern Ireland to reduce spiralling workload and mitigate the impact of the crisis in general practice.

They will also refuse to take on some extra work associated with secondary care, including not seeing patients who have missed hospital appointments, referring patients back to hospital for test results and not organising patient transport.

In addition, GPs will not be completing insurance or PIP forms, BMA Northern Ireland said.

Dr Tom Black, GPC Northern Ireland chair, said: ‘In the absence of a rescue plan for general practice, and to help address the ongoing crisis and as a response to funding cuts, we have had to take steps to withdraw some services, so that we can maintain our core service – seeing patients.’

He said the first step would be to cut back on unnecessary paperwork.

Dr Black said: ‘We will also be advising patients that the hospital is responsible for notifying them of the results of any tests, investigations or treatment they had in hospital.’

Meanwhile, telephone triage will be used to make sure appointments are directed to those who really need them and encourage more patients to self-care and seek help from a pharmacy.

Dr Black who has just been voted GPC chair for another year, said the options were an ‘à-la-carte menu’, which practices could look at and see what was appropriate to their needs.

He said: ‘GP practices have to prioritise clinical work – actual time spent with patients – by withdrawing some services previously provided by practices.

‘This will free up more GP time for direct patient care.’

He added that half-day closing would only be considered if a practice ‘was under such pressure that it would actually improve the service to patients’.

The measures detailing how GPs will work with hospitals are based on a set of standards already introduced in England but which had not been agreed in Northern Ireland despite the BMA pushing for them.

Undated resignations are still being collected by the BMA after the vast majority of GPs said they were willing to walk away from the NHS.

It is thought as many as 20 practices could close this year as GPs grapple with excessive workload and severe recruitment problems.

Amidst political standstill there has still been no funding for the rescue package which was agreed at the end of 2016 to prevent the collapse of general practice.

Last week it emerged that GPs would lose £1m of funding after a series of practice mergers skewed the QOF calculations for 2017.

Dr Black said LMCs would now be writing to hospital trusts to inform them of the work that GPs will not be doing and expect secondary care to be responsible for.

He added that all the measures agreed by the GPC were ‘within contract’.


Readers' comments (7)

  • Unfortunately I don't think this is enough.... any money that the government gives (in exchange for DUP support ) for health care will be immediately sucked up by secondary care.......I wouldn't be worried about 'within contract'.... I'd simply hand the contract back.... I don't think anything else but this will really concentrate the minds....the government still doesnt see any crises in General practice.....until you get an actual disaster the government doesnt do anything......I think a mass resignation is the public disaster that needs to happen.... the government know we're all talk and no real action, unless we take the nuclear option

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  • Cobblers

    Wrap the government bleeders across the knuckles lads eh? That'll learn them. Not.

    Agree with McD. You'll never have a better time. No Stormont. No effective Government in UK. The contract is not delivering. Hand it back. Sort out either an alternate delivery system or have a two week break and sit back. (Finances permitting)

    Or continue down the same road you and the rest of the sheep seem determined to go down. If you look it's called Abbatoir Lane.

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  • We need to do this. How much I would love to stop doing insurance forms and writing 'To Whom it may Concern letters' so someone can sit an exam by themselves. We need a unified approach. Like in NI

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  • A better approach to refusing to do insurance forms would be for all practices to charge insurance companies a commercial rate for them. All practices, not just Northern Irish practices, are free to charge what they judge to be an appropriate rate for the provision of private reports.

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  • Funny about this insurance thing- I am actually glad to be able to do reports as it is one lot of income NHSE is unable to bully me out of!

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  • If you allow people to treat you as a doormat that is exactly what they will do.

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  • For my practice I feel closing our list and not seeing temporary patients would send a clear message. To get round any "duty of care" issues we could see them privately for 50 notes per consult or direct them to casualty. For the few that would pay, we could give a receipt and suggest they try to get a refund from the NI DOH. This would also send a clear message to our health "chiefs". This is a relatively simple action to organise and it would not take long for disgruntled patients to be complaining+++ to the media and others.

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