Northern Irish general practice needs an extra £33 million per year in recurrent funding, the BMA has argued in a comprehensive strategy report.
The document, which shows that Northern Ireland has more patients per GP than anywhere else in the UK at a lower-than-average funding, also calls for an extra 46 GPs to be trained every year to cope with a rise in population.
Making the case for extra funding – which would bring it up to the UK average – Northern Irish GPC chair Dr Tom Black highlighted advanced and voluntary movement by GPs in the country to federate and set up not-for-profit provider organisations that will provide extended primary care in the community.
According to the strategy document, a majority of Northern Ireland’s 351 GP practices are now part of such a federation and all are expected to be part of one by the third quarter of 2015. By 2016/17 it is expected that all of these provider networks will be offering a pharmacist service, phlebotomy (blood testing) and ‘a full spectrum’ of outpatient services.
Health boards are also expected to have devolved the budgets for community nursing, diagnostics and prescribing to the GP federations by 2016/17.
The report said: ‘There has been an increase in workload, coupled with a decreasing workforce. Rising patient demands and expectations are occurring against a backdrop of increasing financial constraint. This is deeply concerning; the impact on health and social care will be significant, putting the future of general practice at risk.
‘We have calculated that there is currently an under-investment in general practice in Northern Ireland. To bring us up to the UK average, there would need to be a recurrent investment of at least £33 million per annum.
‘Funding for health and social care will always be outstripped by demand. That is all the more reason to invest in general practice. If general practice is unable to cope, the knock-on effect on the overall system will be great. There is a need now, more than ever, to invest in a GP-centred service in order to achieve overall savings, through improved efficiency and effectiveness in the longer term.’
Key points highlighted in the report
Workforce:
- There are 351 GP practices in Northern Ireland
- Of the 1171 GPs, 55% are men and 45% are women
- The average list size of 1641 patients per GP is the highest in the UK
- There are 61 GPs per 100,000 patients in Northern Ireland, which is lower than elsewhere in the UK
- There needs to be 46 more GPs trained per year in order to meet gaps in workforce
Funding:
- £241million was spent on GMS (general medical services) in 2013/14
- GMS spend in Northern Ireland is 6% of the total health spend. The UK average on GMS spend on health is 8%
- This results in a lower investment per patient in Northern Ireland despite relative health needs in Northern Ireland being higher than in other parts of Great Britain
Demographics:
- The population of Northern Ireland is projected to increase by 8% to 2 million by 2025
- The number of people aged 65+ is set to increase by 42% to 370,000
- The number of people aged 85+ is set to increase by 82% to 55,000
- The prevalence of long-term conditions such as diabetes, respiratory problems, stroke and obesity is increasing
Source: BMA
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