Northern Ireland GPs agree cuts to non-core services as crisis deepens

GPs in Northern Ireland have agreed to cut non-core services and could close their patient lists in response to the deepening crisis facing the profession.

GPC Northern Ireland chair Dr Tom Black
GPC Northern Ireland chair Dr Tom Black

GPC Northern Ireland (NIGPC) has issued advice to practices on ‘unnecessary’ work they should drop to addressing spiralling workload and underfunding.

Practices have been told to consider closing their lists to new patients if they face unsafe workloads - with many struggling to cope with more than 2,000 patients per GP - and to close for half a day to improve practice efficiency.

GPs in Northern Ireland will no longer re-refer patients who miss hospital outpatient appointments or accept referrals back from hospital for directly related onward referrals, GP leaders warned.

Telephone consultations

Practices will also carry out more consultations by phone, limit paperwork including forms for insurance and PIP reports and stop prescribing some over-the-counter treatments.

The move comes after officials at the Northern Ireland health department last week refused to step in to prevent £1m QOF losses for practices, a knock-on effect of increasing list sizes as practices are forced to merge and close. GP leaders said that around 80% of practices would lose funding because of the anomaly.

NIGPC is already co-ordinating the collection of undated contract resignations in preparation for practices to leave the NHS in response to the funding, workload and workforce crises. GP leaders have been preparing to meet political parties to push for implementation and funding for a reform package agreed by the last executive in December, before it collapsed.

NHS funding

NIGPC is demanding investment of 10% of the healthcare budget in GP services, training and recruitment of more GPs and a reduction in bureaucracy and IT improvements.

The BBC today reported that  the DUP is demanding £1bn funding from the Conservative UK government in return for a confidence and supply agreement in the House of Commons.

NIGPC chair Dr Tom Black said: ‘In the absence of a rescue plan for general practice, and to help address the ongoing crisis and as a response to funding cuts, we have had to take steps to withdraw some services, so that we can maintain our core service – seeing patients.

‘As a result, we are firstly advising GPs to cut back on unnecessary paperwork. This will include not dealing with patients who do not attend a hospital outpatient appointment, instead we will ask them to speak to the hospital directly to make a new appointment.

‘We will also be advising patients that the hospital is responsible for notifying them of the results of any tests, investigations or treatment they had in hospital. We will no longer continue to organise patient transport for routine outpatient appointments.

‘GP practices have to prioritise clinical work – actual time spent with patients - by withdrawing some services previously provided by practices. This will free up more GP time for direct patient care."

He added: ‘Many prescriptions are requested for items such as [cough syrup], mouth washes, shampoos and sun creams all of which are available at the local pharmacist over the counter for a small charge.

‘By no longer providing prescriptions for these items it will free up a lot of time at practices and would make phone lines more accessible and mean a GP  has more time to see patients. GPs will encourage patients to buy these routine items from their pharmacist.’

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