Northern Ireland out-of-hours reform plan 'ready by September'

Plans to overhaul out-of-hours care in Northern Ireland could be finalised as early as September, after talks that could lead to GPs taking control of commissioning and providing the service.

Dr Tom Black: out-of-hours overhaul
Dr Tom Black: out-of-hours overhaul

GPC Northern Ireland negotiators have met health and social care board and Department of Health, Social Services and Public Safety (DHSSPS) officials to discuss reforms, and will meet again in September.

GPC Northern Ireland chairman Dr Tom Black said plans could be ready for approval by the end of the month.

The talks follow concerns over recruitment and retention problems during the summer, with out-of-hours sessions left unfilled.

LMCs in Northern Ireland voted in May to take back control ‘of the organisation and commissioning of the delivery’ of GP out-of-hours care.

‘We can’t recruit doctors into the system because there are too few doctors,’ said Dr Black. ‘Nurse triage appears to be ineffective.

‘Doctors are walking away from the system because they are beginning to be concerned about cover arrangements.’ Health officials know that the ‘centralised model’ in operation since 2004 has led to a ‘deterioration in service’, he said.

‘Everybody knows there is a problem that needs fixing, and everybody knows what the solution is.’

Reforms favoured by GPC Northern Ireland would see GPs in control of both commissioning out-of-hours care through local commissioning groups (LCGs), and delivery through non-profit mutual providers.

The plans would not involve GPs taking back individual responsibility for service provision.

Currently, of five local services, three are provided by health and social care trusts, and two by mutuals.

Dr Black said if LCGs were responsible for commissioning the service, ‘we could get away from the centralised, bureaucratic model’.

‘Basically, a local service provided by mutual providers, with a service that faces patients, and not a computer in Belfast. It’s just a matter of reorganising,’ he said.

‘They are going to have to put more money into it because they have removed resource for ten years running. But that can be solved down the line.’

Dr Black also warned against adopting NHS 111 or a similar single number system.

Northern Ireland would ‘do well to be warned of what happened in England,' he said.

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