The overwhelming majority of GPs who attended crisis meetings

across Northern Ireland to discuss the escalating crisis in general

practice have said they are willing to begin the process of leaving the

health service.

The overwhelming majority of GPs who attended crisis meetings across Northern Ireland to discuss the escalating crisis in general practice have said they are willing to begin the process of leaving the health service.

The five ‘roadshow’ meetings, which took place over the past two months and attracted hundreds of GPs from across the country, were held by British Medical Association Northern Ireland’s General Practitioners Committee (NIGPC). 

Of the total number of GPs who attended these meetings, 97% agreed that they are willing to sign an undated resignation from the health service in order to prevent its complete collapse.

The decision to ask GPs to consider undated resignations follows a motion taken at a meeting of the Local Medical Committee (LMC) in March where doctors voted in favour of seeking support for such a mass action if the Department of Health failed to negotiate a rescue package for primary care within six months. 

NIGPC is calling on the Minister for Health to ensure the survival of general practice throughout Northern Ireland by investing 10% of the Northern Ireland Healthcare budget on a safe, sustainable GP service for patients; training more GPs so practices at risk of closure can stay open and meet the needs of patients, and; reducing bureaucracy and improve IT systems so more time can be spent providing care to patients.

NIGPC has warned that if the Department of Health does not act to implement these urgent rescue measures then general practice will collapse across the country.  They are asking colleagues to consider signing undated resignations to force the government to act before it’s too late.

Speaking at the final crisis meeting last night, which was held in County Antrim, NIGPC chair Dr Tom Black said: “What we have heard across all these meetings are the very issues we have been flagging up in general practice for many months now and unfortunately it looks like it’s crunch time.


“While there were some positive announcements by Minister O’Neill recently as part of her Health and Wellbeing plans, until we have greater clarity about the funding for these initiatives we need to move forward with our own plans.”

Speaking about the next steps for NIGPC, Dr Black said: “We will now enter into negotiations with the Department of Health on funding the rescue plan for general practice.  The agreement will then go before the next meeting of NIGPC on 25 January for decision on whether it will meet the needs of the GP service here.”


Notes for Editors:

Read more about NIGPC and to download a copy of ‘General practice in crisis: a report on primary care in Northern Ireland’.

Five ‘General Practice in Crisis’ roadshow meetings were held across Northern Ireland over the past two months. Of the GPs who attended each meeting, the following percentage said they are willing to sign an undated resignation from the health service in order to prevent its complete collapse:

  • Belfast, 26 October 2016 (Ramada Plaza Hotel, Shaw’s Bridge): 97>#/li###
  • Armagh, 09 November 2016 (City Hotel, Armagh city): 95>#/li###
  • Fermanagh, 29 November 2016 (Killyhevlin Hotel, Enniskillen): 92>#/li###
  • Derry, 06 December 2016 (City Hotel, Derry city): 89>#/li###
  • Antrim, 13 December 2016 (Hilton Hotel, Templepatrick): 98>#/li###

The British Medical Association (BMA) is the voice of doctors and medical students in the UK. It is an apolitical professional organisation and independent trade union, representing doctors and medical students from all branches of medicine across the UK and supporting them to deliver the highest standards of care.

The full list of calls NIGPC is making:

Funding

  • A public commitment from the new minister to invest incremental recurrent funding in general practice at a minimum of 10% of the health budget and to rebalance health resources to where care is delivered. Transforming Your Care, [i] envisaged care being delivered closer to home with the expected shift in resources to accompany this. 
  • The provision of an immediate stabilisation fund for general practice to provide emergency support to vulnerable practices at risk of collapse or where safe patient care is compromised such as out-of-hours.

GP taskforce

  • Similar to the NIGPC Rescue Plan Group, the department must establish a task-force to provide support to vulnerable or at risk practices which could include the provision of management resources, clinical input, proactive support that can be called in at short notice. This needs to be developed in liaison with the Local Medical Committees (LMCs).

Workloads

  • It is vital that a national standard is set for a maximum number of patients that GPs, nurses and other primary care professionals can reasonably care for during a working day to maintain the delivery of safe and high quality care.
  • GP Federations are in a position, if properly supported and funded, to provide locality hubs to which practices can refer urgent patients when they have reached the threshold for safe care on any given day.
  • Establish a list of services that are not included in the core GMS contract which practices can chose if they wish to provide.
  • Develop guidance for ensuring that secondary care work is not passed onto GP practices.
  • Review and reduce the bureaucracy on general practice in areas such as QOF and appraisals.
  • Ensure information technology is fit-for-purpose and resourced. For example online/phone triage / AskMyGP.

Workforce

  • We know that there are not enough GPs and we need a clear and credible plan to recruit and train more GPs for Northern Ireland.
  • Immediate resources to fund an expanded and comprehensive primary care team to reduce and relieve GPs workload, including mental health practitioners, health visitors, advance nurse practitioners, physiotherapists and physician associates.
  • Increase opportunities for patients to directly access services such as specialist nurses or physiotherapists to reduce the GP first point of contact.
  • Reduce the bureaucratic burdens of the GP returner scheme.
  • Invest in GP out-of-hours service to enable an expanded and sustainable clinical workforce, addressing issues such as indemnity costs.

What is an undated resignation?

The concept of an undated resignation is that as part of action coordinated by the BMA, the GP practice, in accordance with its own governance procedures (which may in a partnership be by way of majority vote) determines to provide to the BMA with a letter of resignation, addressed to their commissioning body, for the BMA to date and send in prescribed circumstances.

The service of a notice of resignation on a commissioner will take effect in accordance with the contractual provisions. Six months’ notice is the standard provision in or three months when the GP contractor is a sole practitioner, and the GP practice would be required to work out the contractual notice period in the normal way.

What does this mean for patients?

At this stage patients do not need to worry. GPs will continue to see patients as usual. Patient safety is always our chief concern, and it is for that very reason that we are taking this action.

What happens next?

The Northern Ireland General Practitioners Committee have held a series of roadshows across Northern Ireland, open to all GPs, where it outlined the next steps and balloted members as to their willingness to withdraw their services. 97% of members who attended these roadshows said they were willing to begin the process of leaving the health service.

GP leaders will now begin negotiations with the Department of Health on funding for a rescue plan for general practice.  Agreement from these negotiations will then go before the next meeting of NIGPC on 25 January 2016 for decision on whether it will meet the needs of the GP service here.

Does this mean GP surgeries will close?

GP surgeries are already closing – but due to extreme workload pressures, underinvestment and a lack of workforce planning. This action is being taken to ensure the situation does not get any worse.


For further information please contact:

BMA Northern Ireland, 16 Cromac Place, Cromac Wood, Ormeau Road, Belfast BT7 2JB
Telephone:
028 9026 9666   (switchboard)
028 9026 9672   (direct line)
074 0880 9519   (mobile / out of hours)
Email: bmanorthernireland@bma.org.uk 
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