Health Minister Robin Swann has acknowledged that patient access to GP services needs to improve in areas of Northern Ireland.

The Ulster Unionist representative said:

“Primary care is the bedrock of our local health service – the vast majority of initial contacts within the health system originate through it. Over the last two years I’ve had the privilege to meet and get to know so many GPs right across Northern Ireland.

“Yet in early 2020 it was a service I was stunned to see in such a state of internal flux and under so much unsustainable strain. Despite its undoubted importance it struck me that for years previously General Practice had been treated as a Cinderella service – awarded platitudes but given little actual investment or support.

“The problems facing General Practice even before the pandemic were not new - increasing patient demand as the local population gets older, combined with the changing demographics and working patterns within the GP workforce all had contributed to a growing number of pressures within the service.

“It’s regrettable that for so long obvious problems were left unaddressed.  Within weeks of taking office I recognised the service was in a perilous position and that’s why I asked for key reforms to be accelerated.

“The subsequent pandemic, combined with the continued reliance on inefficient single year Executive budgets, has slightly delayed some reforms but substantial progress has still thankfully been made. As part of a wider programme of work last month I announced the next proposed roll-out of primary care Multi-disciplinary Teams, I’ve already introduced Advanced Nurse Practitioners and additional General Practice Nurses, and I’ve introduced a GP Induction and Refresher Scheme and a GP Retention Scheme.

“The commencement of the Graduate Entry Programme at the Ulster University’s Medical School has also been a significant development in the provision of medical education in Northern Ireland.  The curriculum of this Graduate Entry Programme places a very significant emphasis on Primary Care placements, with a high concentration of clinical placements in rural settings in the west.

“It’s clear however that even with these changes the demand for primary care services was still going to outstrip demand unless action was taken regarding the future workforce. That’s why I established a working group to ensure we have the workforce in General Practice we need going forward. Whilst the group has not yet concluded its work, one of its interim findings was the need to increase the number of GP training places by a further 10 in the upcoming academic year. Despite the challenge of operating in the absence of an overall confirmed budget settlement I accepted and implemented that recommendation in full. In 2022/2023 there will be a record 121 GP training places in Northern Ireland.

“The model of primary care has been changing over the last number of years with multi-professional teams and use of technology.  The development of this mixed approach to delivering primary care services has been ongoing since 2016, so is not a new concept.  In 2016, the report of the GP-led Care Review Working Group concluded that GP-led services could not continue to meet rising demand and expectations without urgent action to address the pressures facing the service.

“Telephone first consultations for example allow patients to seek timely medical advice from their GP for both routine and urgent problems.  Whilst I fully accept the advantages and benefits of such a service, I also recognise that the current system still isn’t working as it should.

“Whilst by no means everywhere, in some areas too many patients are having to ring practices far too many times before they get through to somebody on the other end of the line. That’s clearly not the level of service patients should expect.

“In recent months I made £5.5million available to support General Practice over the difficult winter period.  This included £3.8million to support additional patient care covering both General Practice and the Out of Hours Service and £1.7m to further improve telephony infrastructure and improve accessibility, such as the use of on-line systems for ordering repeat prescriptions, helping to free up telephone lines and staff time.  This was in addition to the £1.7million I already invested previously to upgrade GP telephony systems. It’s obvious however that serious issues remain with making initial contact in some areas.

“So I would urge all stakeholders to consider the issues and work with me, or the next Minister of Health, to find and deliver further solutions. I’m by no means blaming GPs or their staff – they’ve performed heroically under the most difficult of circumstances, whilst also playing a huge role in the vaccination campaign. It’s just obvious that some more work is needed to improve patient access.”