Nearly 1 in 20 Northern Irish GP practices have handed back their contract

Close to one in 20 Northern Irish GP practices have now handed back their contracts in just one year, as partners at another surgery announced their departure yesterday. 

Kilkeel Medical Practice in County Down has been running with ‘half the workforce of three years ago’ and its workload has become ‘unsustainable’, according to its notice online.

This is the fourteenth practice in Northern Ireland to hand back its contract in 12 months, out of 316 practices in total, meaning 4.4% of practices have reached this crisis point. 

The current partners at the 9,000-patient practice will end their contract from 1 November and services will resume as normal until that time.

The Department of Health must now recruit a replacement GP contractor for Kilkeel practice, along with seven other practices who are still yet to find new partners or providers. 

According to the Department’s website, contractors have been found for the six other practices, including the Kells and Connor Medical Centre which handed back its contract earlier this month.

Last month, chair of the RCGP NI Dr Ursula Mason warned that around 30 practices were at risk of closure and receiving recovery support, which is almost 10% of the total number.

Dr Tom Black, chair of the BMA in Northern Ireland, highlighted that the contract hand-backs will affect ‘in excess of 5%’ of the population because these practices are ‘bigger than average’.

He told Pulse: ‘The problems we’re facing are that no other GPs want to take these practices. No neighbouring practices want to merge with them, and practices are very resistant to dispersal and re-allocation.’

Kilkeel Medical Practice’s announcement yesterday said: ‘This difficult decision has been taken as the practice has been unable to recruit GPs to fill several vacancies for some time now.   

‘The practice has been operating with half the workforce of three years ago and as a result the management of the ever increasing workload has become unsustainable.’

The Department of Health said there are ‘a number of different options’ to continue services for patients in this area, including securing a new GP contractor or grouping of GPs, or health and social care trusts taking over the contract as ‘an interim solution’.

A spokesperson for the Department said: ‘We want to reassure patients that the existing Kilkeel Medical Practice will continue to retain the contract to deliver GP services for the next six months. 

‘Patients at the practice do not need to take any action. They should continue to contact the practice as normal. We will be writing out to all practice patients to keep them informed as this process begins.

‘The Department acknowledges the ongoing and significant pressures on GP practices, stemming from the fact that demand for their services is outstripping capacity to provide it.’

Dr Alan Stout, chair of the BMA’s GPCNI, said: ‘This is yet more evidence of the rapidly increasing pressure on general practice in Northern Ireland, mainly caused by lack of workforce, significant funding pressures and hugely increased demand.

‘We are hugely concerned about the knock on effect on other practices and on other pending contract hand backs that we are aware of.

‘NIGPC is urgently looking at alternative options to try to sustain some sort of service to patients.’

Dr Black highlighted the scale of the problems facing general practice in Northern Ireland: ‘It will get worse next year and it will get worse the year after, and it will probbaly get worse for the third year after as well.

‘We’re facing a triple whammy here – workforce, workload, funding. All of which will get worse in the next few years.’

The BMA’s GP Committee in Northern Ireland recently secured a suspension of QOF reporting for this year in order to mitigate some of the pressure practices are under. 

Pulse’s recent article on practice closures in Northern Ireland, which is part of the State of devolved nations series, explored the ‘domino effect’ of contract hand-backs and how the country’s political situation is potentially hampering progress.

The country has been without a first or deputy first minister for over a year and civil servants cannot make any ‘political’ decisions, only follow policies previously set by ministers.