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Winter crisis in GP out-of-hours services prompts call for ‘400 more GPs’

Out-of-hours services in Northern Ireland are buckling under the strain of winter pressures as GP leaders in the area call for more GPs to cope with the strain.

Dr Tom Black, chair of the BMA’s Northern Ireland GP committee, told Pulse that adding 400 GPs to the workforce would return numbers ‘to something more near the norm’.

He said the ‘inadequate workforce’ has led to long waiting times for patients looking for a call back from an out of hours GP this winter.

The Southern Health Trust reported waiting times of 34 hours over the Christmas period, which Dr Black said was due to two thirds of out-of-hours shifts going unfilled.

This comes as increasing numbers of GPs across Wales are refusing to do out-of-hours shifts because of unsafe working and poor management.

The trust sent out a text message to GPs who work for the out of hours service on Boxing Day morning asking for volunteers to help, along with a tweet that said the service ‘has been much busier this Christmas than last Christmas’. 

Dr Black said: ‘That again is without precedent and one can only reflect that that’s not a service – that’s an absent service or disservice, so you can see why we’re looking to bring our numbers back to something more near the norm.

He added: ‘If you’ve got that sort of deficit in your workforce and out of hours, it’s pretty much because there’s a deficit overall. We don’t have enough GPs in the system.’

Dr Black added that some patients in the western area of Northern Ireland, served by Western Urgent Care, waited between 12 and 13 hours to receive a call back from a GP over the holiday period.

He said the Northern Ireland GPC reported both Western Urgent Care and South Health Trust to the GMC last spring for being ‘in our view unsafe’, resulting in both providers facing an investigation by the RQIA regulatory body.

This comes as Pulse has shown how GP out-of-hours services keep hundreds of thousands of patients out of A&E each year.

But they are on a knife-edge and services are stretched to find staff and make a profit as they are undercut by extended hours initiatives.

Winter resilience plans

While none of the winter plans detailed any extra funding for general practice, many requested that GP practices provide extended hours to reduce the pressure on A&E departments – including staying open on bank holidays

The plans however did include placing up to three GPs in A&E streaming services to curb secondary care pressures this winter.

But trusts are already struggling this autumn, with four declaring black or red alerts in September and October and GPs have said the strain on A&E will put general practice under even more pressure this winter.

As a result Chancellor Philip Hammond handed hospital trusts £335m to deal with urgent winter pressures in the Autumn Budget statement, while general practice failed to get a mention.