Struggling GPs in Northern Ireland need more help, say doctors

GPs in Northern Ireland have condemned the lack of funding available to provide support and extra training for doctors who underperform.

The Northern Ireland local medical committees conference in Enniskillen called on the Northern Ireland branch of the BMA’s General Practitioners Committee to demand that the province’s Department of Health, Social Services and Public Safety provide enough resources for underperforming doctors.

The motion, put forward by Eastern Local Medical Committee, highlighted the lack of funding for remediation or mentoring schemes for doctors who are struggling and emphasised that practices need to be willing to take on doctors who have had performance problems in the past.

Doctors working in small practices or in deprived areas in particular may find a lack of supporting infrastructure and no specialised training practices where they can be retrained.

“A lot of money has been spent training these people as GPs, and I think it’s very distressing if they find themselves unable to practise because they have remediable difficulties with their performance,” says Colin Fitzpatrick, a GP in Comber who spoke on the motion.

It’s not just about money, he added: structural support is also important. “We need appropriately trained and supported practices that can help get these doctors back into the workforce,” he said. “We need a joined-up approach between our department of health, the deanery, and the profession as to where we’re going to do placements.”

The issue affects the whole of the United Kingdom, says Dr Fitzpatrick, but it’s particularly a problem in Northern Ireland. Wales, for example, has a system of advanced training practices that specialise in retraining doctors, although this scheme also lacks funding.

The lack of resources may become a much bigger problem once revalidation is implemented, because the process could bring to light a high number of doctors who need additional training. In January the National Clinical Assessment Service reported a surge in the number of doctors referred for performance concerns, which it attributed to NHS organisations strengthening their governance systems in preparation for revalidation (BMJ Careers, 19 Jan, http://careers.bmj.com/careers/advice/view-article.html?id=20001804).

The conference in Enniskillen also drew attention to the problems faced by GPs who have been out of clinical practice for a long time time—such as women who leave practice to have a family—many of whom struggle to find a retraining placement and to get funding for their training, even if they’re prepared to work for free.