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Independents' Day

Third of practices in town could close within 18 months

Nearly a third of GPs in Fermanagh, Northern Ireland, plan to leave general practice within the next 18 months, a situation that the GPC warns has 'caught us unawares'. 

Western LMC says that around 12 of the 32 GPs currently working in Fermanagh are planning to quit, which may lead to the number of practices falling from 18 to 12. 

Despite the region’s beauty there have been problems recruiting doctors to take over single handed rural practices.

Dr Martin McCloskey, the secretary of the Western LMC, said: 'There are 18 practices in Fermanagh and I think they will be lucky if there are 12 left in the next 12 to 18 months.’

He said smaller practices are less attractive to younger GPs. ‘I think it’s a more precarious life, there’s more responsibility, there’s less peer support and more difficult to get time off for holidays.’

Some single-handed practices are amalgamating with bigger practices, said Dr McCloskey. 'They are able to keep the buildings going, they have not centralised services.’

Northern Ireland GPC chair Tom Black said: 'It has caught us unawares.

'Twenty five per cent of GPs are over 55 years old. They are all retiring at the same time.’

The Health and Social Care Board is talking to GPs about a sustainable solution.

A spokeswoman said: 'It is hoped that the discussions will lead to a model of care which provides both high quality clinical care and an attractive proposition for young newly qualified GPs to come and work in the rural Fermanagh area.’

Pulse campaigning for support for vulnerable practices

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Copy of Stop Practice Closures-logo-online-330

Pulse has been pressing for immediate support for vulnerable practices across the UK since 2014 through its Stop Practice Closures campaign.

In Northern Ireland, a BMA report earlier this year found that around 75% of Northern Irish practices said they ‘are struggling’ and a further 10% reveal they are ‘unable to cope’.

Wales is suffering an acute crisis in GP recruitment, with health boards in the country now stepping in to help practices at risk of closure. GP Survival found that 20 practices handed their contract back in the last year, including five that closed.

In the previous five years, 33 practices had handed their contract back, including 17 closures.

Health boards in Walesand Scotland are increasingly having to take over the running of practices as many partners are choosing to hand their contracts over to trusts and an increasing number of GPs choose to become salaried employees.

In England, NHS England announced a new tranche of £16 million of funding to support struggling practices.

Health secretary Jeremy Hunt first announced the fund in his ‘new deal’ last year, and NHS England said in December that practices with poor CQC ratings or higher-than-average referrals and prescribing would be prioritised.

Read more about the campaign here


Readers' comments (11)

  • what's new? Its more or less same everywhere, why should GP take blame for someone else's fault. there are better opportunities elsewhere. Those who can leave are leaving, Its not up to us to save this sinking ship. Patients will get service they deserve if they don't protest

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  • 'It has caught us unawares'! I am sorry Tom, we have been shouting about this for years to anybody who would listen, politicians, NI health board, gmsc, bam, everybody knows what will hit us in Fermanagh over this winter and nothing! NOTHING! Has been done apart from the promise of pharmacists in practice and 20 extra GP trainees who won't get sent near the west,
    We are in despair here and we are facing meltdown locally, it is too late for sticking plasters we need root and branch redevelopment of primary care and a lot more investment into general practice to even dream of survival, a sad crisis that was at one time avoidable, shame on all that could help us but chose to ignore rural NI primary care here.

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  • Coming soon to a town/ccg near you all you cardigans.We told you you would not listen is a sad but true state of affairs throughout the UK.

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  • Caught unawares??? What planet has he been on for the last few years???? Who pays this man and why????

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  • Needs large transfusion of whole money stat. Oh shit it's flat lining . Why did we ignore that falling haemoglobin for years ?

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  • Soon this will not be a headline. Soon, this will be one in a list.

    I repeat 'You don't understand and you do not have a plan for the post-nhs world.'

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  • This has caught us unawares.........Practices across England are gleefully ignoring the inevitable; Partners that don't comprehend business, practice managers ignored or disenfranchised. WAKE UP!

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  • Governments have been warned about this for the past 15 years or longer. They promised more GPs, they promised more midwives, they promised more CPNs and more district nurses. All these promises over the years and nothing is done. Collapse. Such a shame. In the late 1980's when I entered GP. we had poor remuneration compared to Consultants, be we had great teams, of midwives, D.N.s and CPNs and Psychiatric services. Where are these services now ?

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  • I remember GPCNI quoting that small rural pratices would be the "canaries in the mine". Also "domino effect" destabilising surrounding practices. That was over a year ago.
    The demograhic of those GPs in these areas was obvious to all. A blind man on a galloping horse could see what was coming.
    "Taken unawares", I don't think so!

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  • A cut in % GP funding from 11 in 2004 to 5.5 in 2015 as a share of the NHS is clear cut indication from the DOH in NI that they do not care about GPs. A few weeks ago an extra 62 million was released for the NHS in NI. Of that,180000 was for GPs who see 90% of all consults in the NHS.
    No body cares for GPs or GP land, so let it go and do not bemoan its fate.
    An Eire system is coming.

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  • Mr Mephisto

    The Northern Ireland Assembly seems to find plenty of money “down the back of the sofa” to bail out secondary care but have given nothing to Primary Care which is on the point of sinking without trace. One sibling is plied with cash and resources whilst the other is starving and neglected. There are now 50% more hospital consultants than GPs in Northern Ireland (1000 GPs vs 1500 consultants) – that can’t make sense in anyone’s world. One sibling bloated, unfit and on the point of having a major cardiovascular event whilst the other sibling is rummaging through the garbage trying to find scraps to live off. One sibling is treated with kid gloves like a spoilt brat whilst the other is beaten regularly by politicians and the press. I think some form of re-balancing is needed here. Both siblings need to be treated equitably. In this case I’m all for stopping stuffing Peter and giving Paul something to live on.

    The current policy of giving all the money to Secondary Care and giving all the work to Primary Care has obviously failed. Ploughing all your cash into Secondary Care obviously doesn’t work. We need a fundamental re-set of the entire system and we need it now. Hopefully the long awaited Bengoa report will give us some hope for the future. If they don’t then our health care system in NI is bankrupt. My main concern is that the ship has already sailed and any attempts to resurrect primary care will be too little too late

    Our new Health Minister has decided to launch her new brief with the standard “something must be done about waiting lists”. She has obviously learnt nothing from her predecessors. Ploughing all of your resources into secondary care whilst starving primary care has failed to work up until now – why does she think it will work this time around? Waiting lists will be a relatively minor problem once general practice collapses and vast tracts of the country end up un-doctored. Within five years there will be no doctors in any of the rural border areas including in the current health ministers own constituency. The Northern Ireland Assembly will have demonstrably failed in a primary role of government- providing health care for its people.

    It looks like the NI Assembly have taken a very bold move towards a "total secondary care" model of service once General Practice collapses in Northern Ireland.

    Northern Ireland Politicians and Civil Servants need to abandon their failed "give all the money to secondary care and give all the work to primary care model" (Transferring Your Care). All parties need to acknowledge that primary care in Northern Ireland is on the point of collapse. Doing what you have always done and expecting a different outcome is just plain stupid. There is obviously no long term planning or even plain ordinary "thinking" going on in the Department of Health in Northern Ireland just plain old knee jerk short-termist politics - long waiting lists = unhappy electorate = more money to deal with the waiting list "problem". If no-one in Stormont has the sense to actually make changes we are all sunk. What will happen when primary care does implode sometime in the near future? What is the model then? Everyone turn up to A&E?

    Since the good Friday agreement and the devolution of Health Care to the Northern Ireland Assembly we have had a succession of health ministers who have been more interested in playing politics, posturing, and navel gazing than sorting out our health care system. The have been advised by civil servants who are the only ones who have had any knowledge of how to run public services. None of the health ministers to date have any relevant skills or training in anything worthwhile that they have brought to the job. The civil servants have tried to block some of the more “out there” policies some of these individuals have wanted to introduce. This positive aspect of civil servant behaviour has been more than negated by the fact that the civil servants have also served their own agenda. The civil servants have been less than truthful about their own successive failures in running the Health Service. This has led to collusion in both camps where neither side has been honest or truthful about the compete omnihambles that they have both consorted to create.

    Last year The Northern Ireland Assembly found £40 million "down the back of the sofa" to invest in health care. They gave £39.1 million to secondary care and £0.9 million to Primary Care - it shows how much they value Primary Care. We will see how well A&E copes when the GP system implodes. All that cash that they invested in A&E would have gone a long way to stopping the rot in GP land. The rural areas are starting to implode already with practice closures. Within the next five years rural border areas in South Armagh, Fermanagh, and West Tyrone will be un-doctored. Let the politicians try an explain that to their electorate. "Transferring Your Care" is a great political whizz -they give all of the money to Secondary Care and all of the work to Primary Care

    The BMA published statistics in February 2015 in a publication entitled “General practice in Northern Ireland: The case for change”

    There is a very telling graph on page 11 of the document (figure 10) which shows the massive explosion in medical registrar and medical consultant numbers from 2007 onwards.

    So much for "Transferring Your Care" + "The Dump Left"

    The Department of Health need to put their money where their mouth is and start betting on a different horse.

    The horse that they have been betting on all along is just about knackered and their alternative bet is on its last legs.

    Simon Stevens the NHS England director of primary care commissioning said that “we need far more GPs than we need more consultants”.

    The workforce planners have obviously made an omnishambles of this one!

    Currently in Northern Ireland there are 50% more hospital consultants than there are GP’s – 1000 GP’s vs 1500 hospital consultants (approximate figures).

    These figures do not take into account staff grade or associate specialist posts.

    These are official government figures.

    If you told the average man on the street there are more hospital consultant in the country that GP’s they would tell you that you were mad.

    Unfortunately the figures are true and it’s the facts that are mad - proper Alice in Wonderland mad

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