As many as 22 GP practices in Northern Ireland are at risk of closure due to increased demand and loss of doctors, the country’s most senior GP has warned.
BMA NI council chair Dr Tom Black told Pulse that the Department of Health’s ‘crisis team’ is now looking after 22 practices which are on the brink of having to hand back their contracts.
He said: ‘The Department of Health set up a crisis team about four or five years ago to look after practices that were very vulnerable.
‘They move in and try and apply as much in the way of locums or multidisciplinary teams as they can to prevent collapses.’
But he said that it is nearly impossible to find locums.
‘In my own practice, I’ve seen one locum for one day in the last 11 months, which is extraordinary.’
Dr Black said: ‘I think a number of them [the 22 practices in crisis] will hand their contracts back, but we don’t know how many, and the more help we get them, the fewer it will be.’
Meanwhile, speaking on BBC Good Morning Ulster, Dr Black said that the extra workload of looking after patients on the elective care waiting list has pushed some GPs into early retirement.
He said: ‘That workload in addition to the usual workload that GPs do has just accumulated into this situation, where practices are closing.’
Dr Black said there has been a 50% increase in retirements of doctors in the UK, also partly due to issues with GP pensions.
He explained: ‘That’s because of perverse taxation arrangements, such that if you stayed on, you would attract huge tax bills.’
Stakeholders have been unable to find replacement GP partners to take over practices in crisis, meaning some are being taken over by local trusts.
On the Dromore and Trillick GP practice which has recently handed back it’s contract, Dr Black said: ‘It couldn’t find anyone to take on the contract. We tried very hard through usual channels to find a contractor… and it failed. So the Western Trust has taken it over.’
He said this was ‘not an ideal arrangement’ because the trust ‘also has the problem of where to find enough GPs and nurses to run the practice’.
He added: ‘And the primary practice in Belfast is so big, it’s too big to fail. It’s also too big to disperse the patients among neighbouring practices because then you’ll create a domino effect and bring down other practices.
‘They have six months before the present practice leaves the contract, so they have time to look for an alternative contractor, but it may well fall to the local Health and Social Care Trust to run that practice.’
Last week, the GPs running Priory Surgery and Springhill Surgery in Holywood and Bangor, which provide GP services for 14,525 patients, announced they would be handing back their contract next year.
In an update on the practice’s website, the GP partners said: ‘The current GP partners at Priory Surgery (including Springhill Surgery) will no longer be providing General Medical Services from 1st February 2023.
‘The Strategic Planning and Performance Group (which replaced the former Health and Social Care Board) are seeking a replacement GP contractor or a group of GP’s to provide General Medical Services to the patients currently on our practice list.’
Locum rates of £1,000 per day were recently reported in Northern Ireland.
The Irish News reported in June that the Northern Ireland Department of Health offered GPs the fee to provide cover for two daily sessions on dates in July and August at a rural Co Tyrone practice facing a staffing ‘crisis’.
It said this is ‘more than double the standard rate of £440 per day’.
READERS' COMMENTS [4]
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I am a gp in the west of Northern Ireland and a senior federation board member and I can testify that Toms predictions are very optimistic indeed
In my patch, no practice is safe, none!
We are now in the end game here for primary care, with no prospect of things improving for years to come.
We have no government sitting and this stops any major investment in primary care from happening.
For example, we were promised an MDT in April this year which would have helped a little, this has been stalled because we have no health budget agreed at Stormont
There are no locums available and over 50 % of our local gps are over 55 years of age and most are actively considering retirement as the situation has deteriorated so badly
So, although Tom’s headline may seem frightening, the reality on the ground is so much worse than the figures that he quotes
I have been a GP for 32 years, I am beyond broken with how our service has been depleted, sadly, the apns contracts that will replace the gms contracts that will be surrendered will be so much more expensive to fund than proper support for traditional GP would have been
If I were 28 years of age again, I would certainly not take a gp partnership job right now and most of the younger doctors already know this reality,
We are passed rescue right now and the best that can be hoped for is some form of damage limitation to maintain some sort of primary care in rural areas where patients have few options for accessing any health care whatsoever
the standard rate of £440 per day ?
you’re having a laugh !
As a retired GP from NI I can speak from my own experience having handed back my single handed Contract in 2019
I too was a member of our LMC and FEDERATION and did warn my colleagues that letting the small practices close and merge would only be a short term ,short sighted solution to an existential problem.As we can now see all the small practices have been absorbed and the tsunami of existing issues have still prevailed leading to big practice issues with list sizes of 15000 that can longer be covered up with mergers.The Dominoes have just got bigger. Tom talks about the “crisis team” this was a useless sticking plaster in 2019 and now in 2022 an empty fire hose trying to put out to many fires. Basically Tom is explaining the problems but who is listening? Where are the solutions? Personally i cant think of any with a depleted aging workforce in place
Bigger intellects than mine will need to work that one out
ps those that can pay will find a way (Kingsbridge)
These poor hardworking colleagues in NI are the canary in the coal mine. As a seasoned UK GP of 40 years it looks to me like the current guideline/template/defensive way of working is expensive, slow and demoralising. I see no way forward with it. And yet 20 years ago British General Practice was advertised worldwide as a success story.