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General practice in Northern Ireland has ‘turned a corner’

LMC is told of a shift in priorities and funding allocation

Jo Carlowe

Monday, 18 November 2019

General practice in Northern Ireland has “turned a corner,” delegates were told at the Local Medical Committees’ (LMC) annual conference.

Addressing the conference, which took place this weekend in Belfast, Dr Alan Stout, chair of the British Medical Associations’ NI GP committee, said: “There is no doubt that the conversations and the discussions are changing and have changed. Be it at NIGPC, be it at the LMCs, be it with the Board or with the Department of Health there is a definite recognition that if we are going to deliver a strong and a sustainable health service into the future, we will absolutely need a strong and flourishing primary care as the foundation.

“What we are also seeing centrally is a shift in priorities and of how funding is allocated, with a real emphasis on out of hospital care.”

He added: “If we are going to be successful as a National Health Service, we need to move away from historical designations and simply fund the service where it creates the best care for patients and where it will create a changing model; a proactive, preventative and accountable one and away from a reactive, episodic one that is stuck in the past and in old commissioning and funding constraints.

“This will inevitably end up with more population-based care and funding and we have to be responsive and reactive to this and the evolving model of care. The success or failure will not be down to a figure on a sheet of paper or where the money has ended up, but more how the service is delivering the best possible care for patients, at the right time and in the right place.

“MDTs (multi-disciplinary teams) are already making a difference in the areas where they are operational, and we are hearing reports of the significant change to practice workload and pressure and also the ability to start to look at and to do things differently.

“But, we cannot be complacent. We are fully aware that there are still practices in significant difficulty and particularly in areas that do not yet have MDTs. We need to work with these practices and provide as much help as we can, collectively as it is vital that we create the stable environment that we all need.”

Dr Stout warned that GPs in Northern Ireland are now the only health care professionals in the whole of the UK “still paying exorbitant costs for personal indemnity, often running into five figures”.

“This is not only blatantly unfair but also carries significant risk in terms of outstanding liabilities and we need to solve this as quickly as possible,” said Dr Stout.

Premises were also listed as an ongoing priority, with these often becoming “destabilising”  factors within practices, be it through a lease, a sale, or the reluctance of a new partner to buy in.

“We have various projects and various workstreams to try to address this and we will continue to do so.

“Despite these issues, and despite some of the recent health related stories in the press, General Practice continues to excel and to overachieve, and it is a real credit to you all that in Northern Ireland we retain the best QOF outcomes, the best vaccination rates and still manage to provide by and large excellent access to our patients by a variety of measures,” Dr Stout said.

The conference debated a range of issues including Brexit and the challenges it will present; the status of European doctors working in Northern Ireland; workforce including how to attract and retain GPs, the need for a second medical school, and the importance of highlighting GP research.


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