GPs in Northern Ireland face “full blown crisis,” BMA warns

General practice in Northern Ireland is facing a “full blown crisis” that is placing practices at risk of closure, the BMA has warned.

A BMA survey of practices in Northern Ireland found that many were struggling to cope, because of workload and funding pressures and problems in recruiting and retaining doctors. In a report of the findings the BMA warned that most practices in rural areas were at risk of closure, with single handed practices across the province also under threat.1

Three quarters (74%) of practices that were surveyed said that they were struggling, and nearly 10% said that they are “barely coping” with current pressures. The postal survey was sent to all 349 practices in Northern Ireland, of which 229 responded (response rate 66%).

The BMA said the pressure on practices arose from factors such as the growing size of patient lists, increased use of locum doctors to cover staffing gaps, and a surge in emails and correspondence.

Tom Black, chairman of BMA Northern Ireland’s General Practitioners Committee said, “We knew the situation was bad, but the research showed clearly that primary care here is on the edge of a full blown crisis.

“GPs all across Northern Ireland reported problems, but the situation was particularly bad for smaller, single handed and rural practices that have fewer GPs working in them and that are struggling to fill vacancies.

“We were also concerned at the number of respondents talking about retirement: 50% said they expected retirements in their practice in the next two to five years, and this was particularly marked in practices that were already struggling. Those GPs just can’t take the stress any longer.

“We also had GPs reporting that they were struggling to take annual leave and 76% of respondents saying their work-life balance was being adversely affected by their job.”

The survey is the latest phase in the BMA’s campaign to raise awareness of the problems faced by GPs, and the association has urged the government to act to support general practices.

The BMA said that the GP federation model developed by the Northern Ireland General Practitioners Committee had helped GPs deal with the situation but that the model needed to be underpinned by “strategic long-term investment” in primary care.

The committee has called on the government to increase funding for general practice to a minimum of 10% of the overall health budget, to commit to a stabilisation fund to help practices at serious risk, and to develop a special taskforce to support practices at risk.

It has also called for a national standard for numbers of patient consultations a day; a review of bureaucracy that GPs have to deal with; an increase in training places; funding for an expanded primary care team to include mental health practitioners, health visitors, advance nurse practitioners, physiotherapists, and physician associates; and investment in out-of-hours services.

Black added, “We must find ways of securing general practice in the short term and evolve to a modern, sustainable model of general practice for the future to allow us to provide a service that meets the needs of patients.

“The actions we have outlined, if implemented, will go some way to address the crisis facing general practice. This is a matter of urgency—not only to rescue general practice but to ensure that patients in Northern Ireland have a responsive, safe, and sustainable general practice service that they know will be there when they need it.”