Health and care services report

GP surgeries at risk

Staffing difficulties, workload pressures, and inadequate premises are some of the challenges putting GP surgeries at risk in Northern Ireland.

Former Health Minister Robin Swann MLA confirmed that as of the end of September 2022, 16 GPs surgeries were considered to be at risk of closure across Northern Ireland.

Responding to an Assembly question by independent MLA Claire Sugden asking for details on such risks, the former Health Minister said that while reasons varied, some identified risks were those of “staffing difficulties, workload pressures and issues with the fabric/size of premises”.

In recent years the number of GP surgeries in Northern Ireland has been declining, in contrast to rising levels of registered patients.

In June 2022, the BBC reported figures it attained from the Department of Health which showed an almost 10 per cent decline in the number of GP practices in Northern Ireland in just eight years.

At the end of March 2022, there were 310 surgeries in Northern Ireland compared to 350 recorded in 2014. In the same timeframe, the number of registered patients per practice has risen by around 15 per cent to 6,340.

Despite the decrease in practices, the number of GPs, excluding locums, has risen by 20 per cent to 1,419 since 2014.

It is widely recognised that closures of GP surgeries have wider impacts on neighbouring surgeries and their capacity to meet local demand.

Sugden described the figure of 16 practices at risk of closure as pointing to “systemic failure”. The MLA said the potential closures were a result of long-term under-investment and could take years to rectify.

“GPs are under enormous pressure at the moment,” says Sugden. “People still find it very difficult to get a face-to-face appointment, which has led to many constituents contacting my office for help.

“If patients cannot get a doctors’ appointment then they are much more likely to attend our already stretched accident and emergency departments. Delays also have a big impact on the outcomes of more serious illnesses.

“Local doctors’ surgeries are the first point of call for the vast majority of medical and mental health concerns. A plan that would divert patients down more accessible routes to the services they need should be considered to ease the pressure that is adding to the number of doctors retiring or leaving the profession sooner than they had planned.”

In September 2022, then Health Minister Swann announced a £5.5 million package of measures designed to help ease the pressures facing primary care services across Northern Ireland.

“This package provides targeted help to parts of the service that are most under pressure by investing £1 million in a new attract, recruit, retain scheme to help attract GPs in hard-to-recruit areas. It also boosts the support team for GP practices who are experiencing difficulty by an additional £680,000,” Swann established.

In addition, it also includes investment of £3 million to support practices across Northern Ireland through the winter 2022/2023 period, giving them the capacity to provide additional in-hours sessions to help meet heightened demand through the winter; up to £800,000 additional investment in out of hours services; and a commitment to progress work to address the issue of GP indemnity.

The former Health Minister also pointed to the convening of a working group to explore issues around access to services, including how technology can be better used to provide improved access for patients, with an initial report from the group scheduled for the autumn.

While welcoming the investment, Sugden says that some tangible benefits may take years and pointed to an urgency to “save these at-risk surgeries while we can”.

“I have called many times for a large-scale revision of how our healthcare system is delivered. More money will always help, but we also need the appropriate structures and policies in place that will enable the best care to be delivered as soon as possible to everyone who needs it,” she says.

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