Like the Republic of Ireland, general practice across the border is also experiencing a huge range of challenges. Almost one-in-three GP practices in Northern Ireland has been forced to seek crisis support services from the General Practice Improvement and Crisis Response Team in the last four years, according to findings of a report on Access to General Practice in Northern Ireland, by the Auditor General Dorinnia Carville. The report examines myriad challenges that have contributed to these crisis conditions and highlights an urgent need for strategies to resolve them.
Commenting on the findings, Ms Carville stated: “For most people, GPs are their first point of contact with the healthcare system and the gateway to other services. Today’s report reflects the extreme pressures GP practices are facing. These pressures have been driven by a combination of long-term trends, such as an ageing population and growing waiting lists in secondary care, and more recent issues such as the impact of the pandemic.”
The report also states that between March 2022 and March 2023, a total of 13 practices in Northern Ireland either returned, or gave notice to return, their contracts. Despite alternative providers being put in place, most of the arrangements are temporary. Additionally, the urgent need for locum practitioners has resulted in Trusts paying up to £1,000 (€1,167)/day in some instances, which is anticipated to distort the locum GP market.
A number of factors can be attributed to the current situation, and the report identifies views raised from the health sector around perceived financial risks and the continued difficulties in securing an adequate and sufficient clinical workforce. It also highlights particular challenges around GP workforce retention. The total number of GPs did rise by around 9 per cent between 2018 and 2023, however, the report warns this data masks changing patterns of GP work, which indicate there has been an overall decrease in whole-time equivalents. Despite efforts to increase the workforce by expanding the number of GP training places, the report found many of the new training places had been taken up by international medical graduates, who are less likely to remain in Northern Ireland after graduating.
The recent report also examines the roll-out of multi-disciplinary teams (MDTs) in Northern Ireland, which was launched in September 2018, with a planned incremental roll-out across over five years. The data notes that by March 2023, MDTs had only been fully introduced in one of the 17 GP Federation areas across Northern Ireland, and partly introduced in seven others. A lack of available, qualified staff was identified as a key constraint in the roll-out.
Ms Carville added: “Measures taken to date have largely been short-term, which can be costly for public finances. At the same time, progress on delivering more meaningful transformation, such as the planned roll-out of MDTs to work alongside GPs, has been significantly delayed. Ultimately this results in patients not receiving the timely support and access to treatments that they need. It is important to note that there are no quick or easy solutions. What is essential now is the development of sustainable long-term plans to address the significant challenges facing GP services in Northern Ireland.”
The full report is available at www.niauditoffice.gov.uk.
