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Funding for GP specialist services cut despite lengthy waiting lists

Funding for GP specialist services cut despite lengthy waiting lists

Funding for specialist GP clinics in Northern Ireland that were taking pressure off waiting lists as been either halved or cut completely.

GPs were offering vasectomy, dermatology, gynaecology, minor surgery, and musculoskeletal clinics under the Primary Elective Care service but now thousands of patients will end up back on years-long hospital waiting lists, the BMA warned.

The vasectomy service has been stopped completely until the end of the financial year at a minimum and the reality is those patients will no longer be able to access the procedure on the NHS with urology waiting lists being about four years, Northern Ireland GP committee chair Dr Alan Stout told Pulse.

Other services have had funding slashed by 50% despite evidence it was having an impact with 50,000 patients seen since it was put in place about three years ago, he added.

It has been a purely financial decision and questions have been asked about an impact assessment on cutting funding but no information on that has been forthcoming, Dr Stout added.

GPs had undergone training and accreditation to carry out the clinics and it was not just a tap that could be turned on and off, he added.

They had organised the scheme so that a different practice acted as a hub for one particularly specialist service that other practices could refer to, he explained.

‘Because of financial pressures they have reduced the funding for all of the services by 50% except vasectomy which has been stopped completely,’ Dr Stout said.

‘It’s really frustrating because all of these patients are just going to end up back on our huge diabolical waiting lists.’

There would be knock on impact for GPs, prescribing, and referrals, he added. ‘It just becomes such an ineffective and inefficient system. A self-perpetuating problem.’

He said the decision on vasectomy not only would increase inequalities by making it only available to those who could pay, it also put all the long-term contraception decisions back on to the women which was not fair.

‘Some have now set up to do this privately because they spent a great deal of time getting training and accreditation and have now lost faith in the system, in the NHS.’

In a statement, the Department for Health said it ‘remains committed to the delivery of elective care services in primary care in line with the strategic direction of the Elective Care Framework’.

‘Despite the ongoing financial pressures across all departments, a total of £2.1m has been secured to support continuation of the Primary Elective Care service model across five pathways (dermatology, gynaecology, minor surgery, musculoskeletal and non-scalpel vasectomy) until 31 March 2024.

‘While the primary care vasectomy service has had to be temporarily suspended, no decision has been made to cease this service. 

‘The department continues to work with GPs to enable continuation of all pathways within the available funding.’

GP practices in Northern Ireland have had less investment compared to last year, despite the BMA warning they were experiencing ‘spiralling costs and rocketing inflation’.


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Long Gone 31 October, 2023 1:13 pm

GP-service terminated with little or no notice to achieve short term savings. Sound very familiar.
No doubt a new “initiative” will soon emerge, pouring the money into secondary care, or contracting with a private provider costing far more than the GP service?

Darren Tymens 1 November, 2023 10:15 am

This is happening in England as well, it just isn’t being publicised. Anyone who has been in practice over ten years will have seen GPwSI and other community based clinics – all highly efficient and productive and much less expensive than the same services run in hospitals – quietly closed down.
The funding for these clinics, once closed, is generally given to the hospitals. The hospitals don’t use the funding to put on extra capacity, instead using the money to plug financial gaps with the ICB’s blessing/collusion, and so the waiting list increases. The hospitals then use the increased waiting lists to ask for more money.
An excellent primary care based USS service run by GPwSIs was recently closed down in my area, apparently without due process, without consultation, or any real notice. They were told the funding was being given to the hospital. When they asked why, they were told it was ICB policy – though nobody seems willing to produce such a policy document.
The local Head of Place is, I believe, the hospital CEO.