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Independents' Day

Fermanagh: GPs forced to reshuffle to tackle crisis

Our new ‘Postcards from the edge’ series features regions where general practice is on the brink of collapse. We take a look at Fermanagh, in Northern Ireland, where workforce re-organisation is starting to tackle the crisis. Emma Wilkinson reports



Closures and mergers of general practices in Fermanagh have become commonplace in the county over the past two years.

An ‘absolute crisis’ point emerged in 2016, when the small practice model many were running under was deemed unsustainable due to a surge of retiring doctors and the inability to recruit young GPs to take over them.

The problems led the BMA’s Dr Tom Black, chair of Northern Ireland General Practitioners Committee, to claim that only five of the 18 practices were viable for the future.

As a result, in the past two years GP provision in the rural county has been almost completely reshuffled.

In December 2016, Maguiresbridge Surgery closed and patients were transferred to Brookeborough Surgery. Then in April 2017, Brookeborough Surgery merged with Tempo to become Brookeborough and Tempo Primary Care Services.

In the same month, Roslea Surgery was closed, forcing patients to complete a 35-mile round trip to Lisnaskea to reach the newly-formed Maple Healthcare health centre.

‘If you look at the situation we were in two years ago, it was an absolute crisis’

Dr Brendan O’Hare

This centre serves patients from Lisnaskea, Roslea and Newtownbutler and serves over 14,000 patients.

Local people are currently waiting on the creation of another medical centre to cope with the new intake of patients, and Newtownbutler Surgery remains open until the new build is complete.

In March of this year, it was announced that Derrylin, Florencecourt and Derrygonnelly surgeries would amalgamate, and become known as Cuilcagh Medical Practice.

The move was prompted by the retirement of two doctors in Derrylin, and sparked concerns from patients about the retention of the three surgeries.

Dr Brendan O’Hare led an amalgamation of practices, which included Ederney surgery in Fermanagh - saving the future of healthcare in the rural village – to create Western Rural Healthcare.

He says the model used to provide GP services in Fermanagh had been preventing young doctors from coming to the area.

‘If you look at the situation we were in two years ago, it was an absolute crisis. At that time, we had 18 practices, and there were seven or eight of those practices that were extremely vulnerable,’ he says.

‘A complete re-organisation of the GP workforce has made it more attractive…for younger colleagues’

Dr Brendan O’Hare

The small practice model being used - single-handed or two doctors - was unsustainable, he explains.

There were younger doctors working in the county as locums who were happy to work within bigger groups when given the opportunity, but were not prepared to take on a one or two doctor practice on their own, he says.

But according to Dr O’Hare the crisis in Fermanagh has now come to a halt due to the re-organisation of practices, which is making it more tempting for younger GPs.

‘I would have to say that at this time Fermanagh has stabilised,’ says Dr O’Hare, whose practice recently purchased a new building in Ederney and has six young GPs.

‘There has been a complete re-organisation of the GP workforce which really has made it a more attractive environment to work in for younger colleagues and it is more sustainable and secure.

‘I would have to say it is a credit to the doctors involved and the decisions they have made as they really have managed to contain the situation and continue to provide high quality care right across the county,’ he adds.

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Readers' comments (1)

  • As some of you know, I am a Gp in Fermanagh and full credit goes to the doctors who have adapted and reorganised to maintain primary health care here over the past 2 years, it is amazing the work that has been done here by dedicated gps
    Having said that, in my opinion the crisis is not over, things may look superficially better but the basic problems remain.
    These are amongst other things: massive underfunding of primary care in NI, political inertia, rurality, changing career aspirations of newer gps etc.....
    Until Gp gets a proper percentage of nhs funding then deterioration of Gp services further is inevitable in my opinion
    Sadly most of the heavy lifting has been done by gps with little or no political or DoH assistance as in NI general practice has been relegated in priority to such issues as flags, traditional marches, Irish language act and most recently renewable heat incentive boilers.
    We do not even feature on the political agenda let alone the media locally
    Sadly pulse, we have not heard the end of ni Gp demise

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