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BMA writes to warn patients GPs may have to turn them away over winter



GP leaders have written an open letter to patients saying practices may be forced to ‘cut opening hours’, ‘stop routine services’ or ‘send patients directly to hospital’ over the next months.

BMA Northern Ireland’s stark warning for winter comes as the UK Government said today that NI public services cannot be sustained much longer amidst ongoing political stalemate.

GPC NI chair Dr Tom Black said there had been ‘abject failure’ of politicians to address the unprecedented pressure facing GPs and no health minister for the whole of 2017.

He said in the letter to patients: ‘Over the winter months GPs and their staff will do their best to maintain vital services for the most vulnerable patients, however it is only fair to warn you that some practices may have to cut their opening hours, stop routine services, deal with cases over the phone or send patients directly to hospital in order to manage workload.’

He asked patients to get their flu jab, deal with minor illness at home and seek pharmacist advice in the first instance.

The letter added: ‘This crisis in GP services has been caused by a lack of funding, a huge increase in workload and a failure to attract young doctors into general practices. 

‘The average GP is now responsible for the care of 2,000 patients.’

The GP crisis in Northern Ireland has been greatly exacerbated by the political limbo with no way to implement an agreed plan to rescue general practice.

There was no new contract for 2017/18 with the previous year’s deal rolled over and BMA figures show there are now just 336 GP practices – down from 365 in 2005 – with the expectation of further closures and mergers.  

And yesterday Northern Ireland secretary James Brokenshire told MPs that ‘time is running out’ to break the deadlock with no formal budget and the country on a path to losing autonomy.

In a written statement to Parliament, Mr Brokenshire said there had been no devolved government for 10 months despite efforts to bring the parties together.

‘The outlook for an imminent resolution is not positive. Time is running out. And without an agreement, we are on a glide path to increasing intervention by the UK Government.’

He stressed a budget must be in place no later than the end of November and if agreement on finances cannot be reached by 30 October, the only option would be for Westminster to intervene.

‘My strong preference is for a restored Executive in Northern Ireland to take forward its own budget.

‘Without an Executive, though, it would be grossly remiss for the UK Government not to step in and take action to ensure the continued funding of critical services in Northern Ireland.’

It comes as the UK BMA’s Annual General Meeting voted overwhelmingly in favour of general practice adopting a hospital-style model of declaring ‘black alerts’ when workload or workforce issues mean they are not safe to deliver care.

The motion, agreed in June, committed the BMA and GPC to establish a black alert reporting system ‘with or without’ the Government’s cooperation.

Conversely, as Pulse exclusively revealed two weeks ago, NHS England urgent care leads had considered piloting a model whereby patients could not turn up to A&E without a GP referral.

The letter in full

OPEN LETTER TO THE PUBLIC OF N IRELAND

Copied to newspaper editors

It is well known that GP services across Northern Ireland are facing unprecedented pressure in terms of increased workload and a severe shortage of doctors. The abject failure of local politicians to address these issues has exacerbated an already critical situation.

Over the winter months GPs and their staff will do their best to maintain vital services for the most vulnerable patients, however it is only fair to warn you that some practices may have to cut their opening hours, stop routine services, deal with cases over the phone or send patients directly to hospital in order to manage workload.

To help manage workload we would encourage patients, where possible, to deal with minor illnesses such as sore throats, coughs and colds with treatment at home. Your local pharmacy should be your first point of call for these minor issues.

We would also encourage everyone who is eligible to get their flu vaccine as we expect the influenza epidemic to be severe this winter.

This crisis in GP services has been caused by a lack of funding, a huge increase in workload and a failure to attract young doctors into general practices. The average GP is now responsible for the care of 2,000 patients.

Dr Tom Black

Chair, BMA Northern Ireland’s General Practitioners Committee