BMA warns of ‘unsustainable GP pressures’ as report finds older people feel ‘shut out’

A new report has highlighted older people’s concerns with accessing care from general practice in Northern Ireland, prompting a warning from the BMA that the current system is ‘not sustainable’.

According to the Commissioner for Older People for Northern Ireland (COPNI), older people say they feel ‘increasingly shut out’ from the health and social care system they paid into all their working lives.   

Issues with GP access – especially appointment systems and telephone triage – are among the most frequent concerns, the COPNI.

The report brings together a survey of over 1,200 older people alongside demographic, workforce and service data, to understand how current pressures are being experienced by ‘those most reliant on the system’.     

General issues with hospital appointments were mentioned as ‘a source of worry and anxiety’ for older people, but issues with GP appointments and GP visits were ‘by far the most dominant theme in the survey’, the report found.

It said: ‘Respondents believed that GP practices are becoming inaccessible to older people. Many of them maintained that it is often difficult—and sometimes impossible—to visit or even speak to a doctor when they felt that they needed it. This, understandably, causes a great deal of anxiety.

‘Significantly, older people—who are more likely to require medical attention and advice—believe that access to doctors has become increasingly restricted in recent years.’

The report acknowledged pressures in general practice, with the number of GP practices falling again in 2025, to 305 (a reduction of seven practices since 2024).

It added: ‘Being a GP is also a less attractive job than previously, as there are today more patients seeking services from fewer GP practices.

‘During 2024/25, around 46,000 first time patients registered with GP practices in Northern Ireland, which represented almost a 2% increase in total registration activity compared with the previous year.’

BMA Northern Ireland council chair Dr Alan Stout, a GP in Belfast, said the access problems described in the report ‘are not the result of indifference or lack of effort’ by GPs or practice staff.

He added: ‘They are the consequence of sustained and growing pressures on general practice, rising need from an ageing population, fewer GP practices, larger patient lists, workforce shortages, and years of underfunding.

‘Many practices have had to adopt telephone and triage systems as a way to manage demand that otherwise would be unmanageable.

‘The current situation is not sustainable, we have said that many times. Restoring general practice and improving waiting times and emergency care requires a clear, long term plan to stabilise and invest in services, support and retain the medical workforce, and match capacity to population need.

‘With the right support, GPs and hospital doctors can continue to deliver the personal, trusted care that older patients value and deserve.’

The Commissioner for Older People Siobhan Casey said: ’Older people are telling us something deeply troubling, that they no longer feel protected by the very system they contributed to all their lives. 

‘The results of this engagement exercise showed that access to services, in particular accessing healthcare services was the biggest concern older people had and the current system is failing older people because demand is rising relentlessly while capacity is not keeping pace. 

‘Anyone who thinks this doesn’t affect them is wrong. We are all ageing. The system we allow to decline today is the one we will all rely on tomorrow.’

A spokesperson for the NI Department of Health said: ‘While noting the ongoing issues facing older people, which are longstanding, the Commissioner has highlighted the significant work being taken forward by the Department of Health in reframing how we deliver services, publicly noting the shift to develop a new neighbourhood health and wellbeing model, which will deliver greater levels of care for citizens in their communities.

‘The Neighbourhood Health and Wellbeing model represents a fundamental shift in how care is designed and delivered, with less focus on hospital and a greater focus on providing early intervention, closer to home.

‘This has the potential to bring significant benefit for all patients and carers, and for older people in particular who are among the most frequent users of these services.’

Last year the Department of Health set out plans to expand primary care teams across the country, including funding to push ahead with growing the multi-disciplinary team (MDT) programme which will ‘open up a million more appointments by 2033’, health minister Mike Nesbitt said.

But BMA warned that a ‘new neighbourhood model of care’ being planned would not happen without first resolving their dispute with GPs.

At the end of last year, the GMC and RCGP used their addresses at the inaugural Pulse LIVE Belfast to call for improvements to GP workforce strategies in Northern Ireland.