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Winter crisis in GP out-of-hours services prompts call for '400 more GPs'

Out-of-hours services in Northern Ireland are buckling under the strain of winter pressures as GP leaders in the area call for more GPs to cope with the strain.

Dr Tom Black, chair of the BMA's Northern Ireland GP committee, told Pulse that adding 400 GPs to the workforce would return numbers ‘to something more near the norm’.

He said the ‘inadequate workforce’ has led to long waiting times for patients looking for a call back from an out of hours GP this winter.

The Southern Health Trust reported waiting times of 34 hours over the Christmas period, which Dr Black said was due to two thirds of out-of-hours shifts going unfilled.

This comes as increasing numbers of GPs across Wales are refusing to do out-of-hours shifts because of unsafe working and poor management.

The trust sent out a text message to GPs who work for the out of hours service on Boxing Day morning asking for volunteers to help, along with a tweet that said the service ‘has been much busier this Christmas than last Christmas’. 

Dr Black said: ‘That again is without precedent and one can only reflect that that’s not a service - that’s an absent service or disservice, so you can see why we’re looking to bring our numbers back to something more near the norm.

He added: ‘If you’ve got that sort of deficit in your workforce and out of hours, it’s pretty much because there’s a deficit overall. We don’t have enough GPs in the system.’

Dr Black added that some patients in the western area of Northern Ireland, served by Western Urgent Care, waited between 12 and 13 hours to receive a call back from a GP over the holiday period.

He said the Northern Ireland GPC reported both Western Urgent Care and South Health Trust to the GMC last spring for being ‘in our view unsafe’, resulting in both providers facing an investigation by the RQIA regulatory body.

This comes as Pulse has shown how GP out-of-hours services keep hundreds of thousands of patients out of A&E each year.

But they are on a knife-edge and services are stretched to find staff and make a profit as they are undercut by extended hours initiatives.

Winter resilience plans

While none of the winter plans detailed any extra funding for general practice, many requested that GP practices provide extended hours to reduce the pressure on A&E departments - including staying open on bank holidays

The plans however did include placing up to three GPs in A&E streaming services to curb secondary care pressures this winter.

But trusts are already struggling this autumn, with four declaring black or red alerts in September and October and GPs have said the strain on A&E will put general practice under even more pressure this winter.

As a result Chancellor Philip Hammond handed hospital trusts £335m to deal with urgent winter pressures in the Autumn Budget statement, while general practice failed to get a mention.

Readers' comments (14)

  • This was predictable . If GPs are doing extended hours they cannot be doing OOH. It is common sense.

    So do you want them do do an extra hour in their surgeries, or an OOH shift ?

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  • Nobody, and I mean nobody, is listening.

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  • Pay properly and you will get more GPs, both in training and therefore in the longterm.
    I'm sure I read an elderly care plan proposed in England, combining GPs with Consultants, and it was planning something like £65/hr for a GP but £300/hr for a consultant.
    That is why no-one wants to do this anymore. I honestly believe it is too late and no-one 'on high' has a clue what to do and nothing is being done to avoid the inevitable.

    Young ones run off to Oz whilst you can, sunshine, happiness and financial reward for your hard work (not just criticism and vilification in the press).

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  • Spot on up the irons, also consider the consultant gets his indemnity paid before the money we don't.We are not valued, what we do is valued and wont be until we are gone.Ther are also more consultants in the workforce than GPs at the moment, but we do 90% of the patient contact.Where is the value on workload alone.

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  • I have got several calls from OOH in last few days, declined to work for peanuts. I would save 25 quids per hour after deducting high rate tax indemnity etc. I am better off sitting at home twiddling my finger. My mortgage is already paid from 9-5 job.

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  • I am not doing any more normal sessions or OOH due to the indemnity.

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  • I considered helping out in recent ooh crisis, but I didn’t, why? Because of the indemnity problem, I am not prepared to pay thousands of my own monies to help out the local trust in times of difficulties, this needs fixed ASAP,

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  • Jones the Tie

    totally agree with the comments. Asking GPs to do additional work for no extra funding is ridiculous . It is ridiculous that they even ask. Everything is directed towards easing A+E pressure as the idiots on high do not understand that GP is crumbling also. They don't even understand the fairly simple indemnity issue but I don't think they care that much really. Folk just need to know they are getting the service that their Government pays for and that is why it is inadequate but there is no simple fix. If you make working conditions risible nobody will want to do the job so there are no '400 more GPs' for NI waiting in the wings etc they've thrown the towel in long ago after their jobs became pretty intolerable and there is nobody rushing to take their place. . It is so galling to see the political excuses whilst watching billions being allegedly thrown at private rail companies etc by the Transport Minister. so..money is found for that but not for failing NHS.. priorities all wrong HMG I'm afraid whilst your mind is occupied by Brexit the country is sinking. All GP goodwill was exhausted years ago so you can no longer rely on it by begging us to help when an inevitable crisis occurs..nobody wants to do the job during the day so doing anti-social shifts in addition to that just isn't going to happen and especially not if indemnity fees issue taken in to account.. I'm surprised the service has lasted this long really and it is only due to dedication by the NHS staff that are left on the ship as she goes down. Jeremy ..stop wearing that bloody lapel badge as you clearly don't give a monkeys about the organisation you are in charge of and your cynical and naive virtue-signalling fools no-one.

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  • The mystery is why anyone is doing OOH work; unpleasant, high risk, poorly paid. Daft or desperate?

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  • The papers say I earn £800,000, PA
    Current 60 hour week to keep the rusting bucket afloat = approx £230 an hour- not ####g £20-30 / hour. They could have my carcass for £300/hr

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