NI Government sets out primary care expansion as GPs continue collective action

The Department of Health in Northern Ireland has set out plans to expand primary care teams across the country as GPs plough on with collective action.

Funding has been secured to push ahead with growing the multi-disciplinary team (MDT) programme which will ‘open up a million more appointments by 2033’, health minister Mike Nesbitt said.

The announcement comes in the same week that GPs in Northern Ireland began collective action ‘designed to reduce the unfunded work’ they do.

Mr Nesbitt said that the early roll out of the programme which brings new physiotherapy, social work and mental health roles has delivered an additional 335,000 patient consultations in 2024-25.

An eight-year implementation plan for the MDT programme said so far the new staff have been introduced across seven of 17 GP federations with the work completed in one of them since its launch in 2018.

It will now be expanded in two phases, with the first up to 2028/29 seeing implementation completed in the initial seven areas, with five more coming on board.

The second phase up to 2033 will see the MDT teams completely rolled out in the five remaining areas, the plan said.

Phase one will be fully funded with £61 million from the Public Sector Transformation Programme with the Department of Health ‘developing plans for the completion of phase 2’, it added.

Mr Nesbitt said his focus on successfully expanding the MDT programme was ‘proof’ of is commitment to expanding primary care overall and delivering more services closer to communities.

But the BMA said the ‘tentative’ announcement would not be enough to reassure GPs who have faced a funding crisis.

Earlier this month NI GPs voted in favour of taking collective action for the first time, following this year’s first-ever contract imposition.

Some of the actions which practices are taking as part of this include limiting patient consultations, serving notice on any voluntary work and insisting on referrals for specialist appointments ‘when clinically appropriate’.

And the BMA recently warned that the ‘new neighbourhood model of care’ being planned by the Government in Northern Ireland will not happen without first resolving the current dispute with GPs.

Mr Nesbitt said the MDT programme was already making a ‘significant difference’ and its expansion would help bolster GP services.

He also encouraged BMA leaders to come back to the table on contract negotiation for next year, while acknowledging that GPs were frustrated with ongoing pressures.

He said: ‘The implementation plan also sets out compelling evidence that the MDT programme helps stabilise pressurised GP services and reduce referrals to hospitals.

‘Progress on implementing the MDT model has been constrained by funding and staff availability. However, this year I have been able to secure £61m of executive transformation funding to push ahead with expansion.

‘I know GPs are frustrated at the current serious pressures and the budget shortfall across health and social care this year.

‘But I can assure them that I am determined to deliver on a neighbourhood centred system of health and social care. I want to involve and empower GPs at every step of this process.’

BMA Northern Ireland GP committee chair Dr Frances O’Hagan said that MDTs alone will not solve the range of problems and issues GPs have, particularly the ‘chronic underfunding’ practices across Northern Ireland are facing.

She said: ‘While today’s announcement gives more detail on how the Department hope to roll out MDTs across Northern Ireland, as the minister acknowledges, GPs need to be front and centre of this work to ensure it addresses the problems it hopes to solve with this expansion of multi-disciplinary teams throughout Northern Ireland.

‘MDTs alone will not solve the range of problems and issues GPs have particularly the chronic underfunding practices across Northern Ireland are facing right now; a tentative promise of future funding is currently not enough to reassure our members that the minister and Department are serious about solving the current, in-year crisis.’