One of the largest GP practices in Northern Ireland, with over 14,000 patients on its list, has handed back its contract.
At the same time, LMC leaders met for the Northern Irish LMCs conference this weekend, with motions aimed at stopping practice closures dominating the agenda.
Passed motions included a call for ‘a freeze of the contract and reinstatement of secured funding that was delivered earlier in the pandemic’.
A motion for an ‘immediate summit’ with ‘politicians and civil servants at the highest levels’ to ‘address the current collapse of practices’ in Northern Ireland also passed.
The BMA’s Northern Irish GP Committee was also instructed to seek ‘a limit on patient migration from practices perceived to be in trouble to enable stability of these practices and a reduction of potential harm to surrounding practices’.
According to local news reports, this domino effect is what has brought 14,000-patient Maple Healthcare in Lisnaskea, Co Fermanagh, to the brink of closure.
The patient list grew as a result of other surgery closures in the area when GPs retired in Lisnaskea as well as nearby Newtownbutler and Roslea, reported BBC Northern Ireland.
Maple Healthcare operators informed the Northern Irish Department of Health of its intention to hand back the contract in a letter last week, citing ‘excessive stresses and intolerable pressure’.
‘The remaining partners find it inconceivable that they could continue to carry the burden of responsibility of running the practice,’ the letter added, although it stated that the centre’s current doctors may be able to provide services if a new contract holder could be found.
Among contenders to take on the contract could be the Western Health and Social Care Trust, news reports said.
At the LMCs conference, GP leaders passed a motion urging for ‘complete transparency’ when trusts take over GP contracts, amid fears new APMS contracts are more generous than their pre-existing GMS counterparts.
Opening the conference on Saturday, NI GPC chair Dr Alan Stout called for urgent help for the profession, which he said was ‘in real trouble’.
Fermanagh, in the South West of the country, has long had problems replenishing its GP workforce, and an ‘absolute crisis’ point emerged in 2016 due to retiring older GP partners at a number of small practices.
In response, health authorities spent two years completely reshuffling general practice in the county. This included moving patients from closing surgeries to the then newly-formed Maple Healthcare centre.
As many as 22 GP practices in Northern Ireland are currently at risk of closure due to increased demand and loss of doctors, the BMA warned earlier this year. They are being assisted by a Department of Health ‘crisis team’, which was set up to look after practices that are very vulnerable.
A £5.5m package of support measures was also announced in September to help ease the pressures facing general practice in Northern Ireland.
The lack of GPs has also pushed up locum rates in the country, with a £1,000-per-day rate reported in one instance.
A statement from the Department of Health confirmed ‘that Maple Healthcare in Lisnaskea have handed back their contract to deliver GP services’.
‘We want to reassure patients that Maple Healthcare will continue to retain the contract to deliver GP services for the next six months,’ it added.
‘We will now begin a recruitment process to put new arrangements in place to deliver GP services.’
Key motions passed at the NI LMCs conference
- That conference calls for a freeze of the contract and reinstatement of secured funding that was delivered earlier in the pandemic.
- That conference calls for an immediate summit to be convened by the Department of Health (DoH) and involving politicians and civil servants at the highest levels to address the current collapse of practices in Northern Ireland.
- That conference instructs NIGPC to seek from the Strategic Planning and Performance Group (SPPG) a limit on patient migration from practices perceived to be in trouble to enable stability of these practices and a reduction of potential harm to surrounding practices.
- That conference directs NIGPC to seek absolute transparency in seeking the wording of Alternative Provider Medical Services (APMS) contracts and the detail around management and staffing spend when Trusts are awarded such contracts. This is sought to ensure that there is equivalence between the funding of a GMS contract before handback and the running of a practice by a Trust under APMS afterwards.
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