GPs in a number of areas with severe staffing problems are to be offered £2,000 cash bonuses to sign up to work out of hours.
Northern Ireland’s Health and Social Care Board has allocated £300,000 to fund the new enhanced service, which will be offered to GPs in Belfast and the South and South Eastern regions.
GPs who have never worked in out of hours or who has not done so for more than a year are eligible to work under the new LES, which the board hopes will ‘increase the medical manpower of the out-of-hours services in those areas’.
The cash bonus, which comes as a Pulse investigation in January revealed that individual GPs sometimes covered 370,000 patients overnight in South and West Northern Ireland, is dependent on GPs committing to do out-of-hours work for three to six months and complete the requirements of the LES.
A shortage of GPs, compounded by high levels of retirement and a lack of younger doctors, as well as rising indemnity costs, have been blamed for the staffing problems seen in out-of-hours services throughout the UK.
A letter sent to GPs in the three areas outlined an offer of a £1,000 bonus for working 25 hours over three months – including six hours training time – on top of pay for covering out-of-hours shifts. A further cash incentive of another £1,000 is paid after six months.
Each of the areas will receive £100,000 under the LES to ‘encourage local GP principals, salaried GPs and sessional GPs who have not worked for any of Northern Ireland’s five GP out-of-hours [services] in the past 12 months or more, to do so’.
The ‘A New Start GP OOH LES’ will also involve taking part in induction and introductory ‘taster’ sessions as well as ‘advice, support, information and training to make their return to out of hours work a more positive experience’.
A Health and Social Care Board spokesperson said: ‘The out-of-hours service is facing challenges due to increasing demand and difficulties associated with recruitment and retention of GPs.
‘Over the past few years, fewer doctors have made themselves available to work out of hours, particularly at busier periods.’
Dr Alan Stout, BMA GP Committee deputy chair for Northern Ireland, said ultimately a longer term solution was needed.
He said: ‘We have a crisis in GP manpower both in and out of hours. We ultimately need to increase the out-of-hours rates – which have been unchanged for 11 years – to attract people to work in the service but also to cover ever increasing costs and in particular indemnity costs.’
He further suggested that the Health and Social Care Board was being forced into short-term measures such as this LES because of the lack of a current Government arrangement in Northern Ireland.
He said: ‘Without a [health] minister and without a budget and an agreed rescue plan there cannot be a rate enhancement and so projects like this are required to try to attract new doctors into the system and to cover their costs, never mind pay them appropriately.
‘It will be interesting to see what the result of this will be in terms of numbers, but long term more definitive change is needed including reviewing the overall model and reviewing the rates.’
GP out-of-hours staffing woes
Out-of-hours GP services are on a knife edge across the UK, with providers covering some four million patients admitting they have had overnight and weekend shifts over the past year with no GP cover, as a Pulse investigation revealed earlier this year.
One in ten areas admitted this was the case, while in the South and West of Northern Ireland GPs reported that the service was ‘broken’ with individual GPs regularly having to cover populations of 370,000 overnight.
At the time, GP out-of-hours leaders say this is part of a ‘worrying trend’, with fewer clinicians available and services often relying on non-medically qualified urgent health practitioners, nurses and paramedics.
In England, NHS leaders have focused on the disincentive of high out-of-hours indemnity premiums, by covering these in full during the winter months to try to boost the GP workforce.