Exclusive The recently announced budget for Northern Ireland will likely mean millions of pounds worth of cuts will be made to GP funding, Pulse understands.
Last week, the Northern Irish Department of Health published an impact analysis of the budget, projecting a funding gap of £732m for this financial year and highlighting the need for £360m in savings or efficiencies.
Pulse understands that the Strategic Planning and Performance Group (SPPG), the body responsible for delivery of health services, has been asked to make cuts to primary care in order to balance the books, and this could mean around £5m is taken out of core general practice funding.
This comes as 16 practices have now handed back their contracts in the last year (see box) and as the chairs of the Northern Irish and English BMA GP Committees today wrote to chancellor Jeremy Hunt with an urgent request to top up GP practice coffers.
Around 30 practices are currently receiving crisis support, which paired with the 16 hand-backs and more seeking support every week, the number of practices in crisis is up to 50, according to a spokesperson for the BMA NI.
Out of the 317 practices across the country, this means more than one in six are under pressure and at risk of closure.
Dr Alan Stout, chair of Northern Ireland’s GPC, said he is ‘seeing a huge number of practices in trouble’ which is the ‘destabilising neighbouring practices’.
At the end of April, the secretary of state for Northern Ireland announced a £7.3bn budget allocation for health for this financial year.
Chair of the BMA’s NI Council Dr Tom Black criticised this ‘piecemeal approach’, calling for a multi-year budget, and highlighted the ‘lack of any significant uplift in funding’ which would have a ‘major impact’ on patients and staff.
He said: ‘It will become more difficult to make an appointment for your GP, more difficult to access ambulance services, longer waits for ED and longer waits for outpatients and inpatients.’
And in response to the impact assessment last week, the BMA NI tweeted: ‘We can’t keep doing more for less, the figures outlined today will have a devastating impact on patients and the workforce.
‘We need our local Assembly and Executive in place to begin addressing these problems.’
The 16th GP practices to close in one year
The tally of NI practices to hand their contracts back in the last year has now reached 16, after a new contractor for the Racecourse Medical Centre in Derry pulled out last week.
The practice reached the end of its contract yesterday. Last week, Derry Now reported that Dr Ravinder Kumar, who had been appointed to take over the 5,000-patient practice, had pulled out.
The Department of Health has confirmed that the local Western Health and Social Care Trust will temporarily take over the contract from today.
This follows a contract hand-back in Ballymena last month, where three partners at the Cullybackey Medical Practice retired which left the remaining two GPs with an unmanageable workload.
And a further 14 practices which had to hand contracts back in the last year.
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.
Announcing the funding shortfall for health, the Department of Health’s permanent secretary Peter May said he and his civil servants are ‘in an impossible position’ of trying to balance budgetary concerns with the public interest and safeguarding services.
He said: ‘Decisions are required that we do not wish to take and that are not in the best interests of the health and social care system.’
He called on the Department of Health to work with GPs to address the ‘underlying issues’ in general practice rather than implementing short term solutions to prop up struggling practices.
It is not yet clear where all the savings or cuts will be made in general practice, however the department’s impact assessment stated it has had to ‘reduce the planned capital allocations’ for ‘investment in the upgrade of GP practices’.
On the number of practices in crisis, Dr Stout said: ‘I am being contacted daily by GPs from across Northern Ireland who just don’t know what to do any more.
‘They are overwhelmed with the amount of work, they are facing increasing costs in running their practices, they are paying their own indemnity fees, there are only a finite number of locums to help out and they cannot find younger doctors willing to take on partnerships.
‘The situation is very fragile and there is huge potential for further destabilisation.’