MLA raises concerns over access to GP services

Amid ongoing concerns in the community around accessing local GP services, North Antrim MLA Paul Frew has written to Health Minister Robin Swann, after receiving “so many complaints” about the GP phone first system.

The local MLA commented on the issue, saying:

“People are concerned that their loved ones will not be seen in a timely fashion or something be missed that could be life changing or threatening.

“A number of constituents who I have met over the past few months believe that their loved ones passed away not having received the proper care and attention and they are left wondering could early intervention have made a difference.

“Due to pressure we have applied, the Department has established a Working Group to explore issues around access to GP services, including demand for services, limitations of infrastructure, and staffing and resourcing issues.”

Mr Frew asked Health Minister Robin Swann:

“To ask the Minister of Health what surveys have been conducted to ascertain how many people will go undiagnosed, misdiagnosed, fall seriously ill or die as a result of the GP phone first system.”

In response the Minister replied:

“GP phone first system has allowed practices to maintain the majority of GP services and has enabled GPs to appropriately manage, treat and support a greater number of people than would otherwise have been the case.

“With the level of pressure on the service continuing to rise, the use of telephone consultations are an important part of how GPs can treat and support the large number of patients who need their services.

“With the GP phone first system the GP determines the most appropriate approach to safely addressing the patient's needs using their clinical expertise. Where a face to face appointment is appropriate, that will be arranged. Alternatively, the GP may decide, based on their clinical assessment, that a telephone consultation is appropriate or that the patient should be signposted or directed to other relevant services.

“In terms of diagnoses, GPs are still expected to clinically assess for risk of serious illness and refer as clinically appropriate for diagnostic tests and to specialist services such as an outpatient clinic as they have always done.

“GPs want anyone who has a health concern to feel reassured that they will be able to get an appointment and see a GP if necessary. If people have symptoms or an unexplained illness or have any reason to be concerned, they should in the first instance contact their GP who will be able to provide

advice.”

Mr Frew also asked the Health Minister the following:

“To ask the Minister of Health when people will be able to avail of their GP services and surgeries at pre-pandemic levels.”

Health Minister Robin Swann responded:

“Prior to the COVID-19 pandemic, Primary Care services were already coming under increasing pressure. Figures in 2019 indicated patient contacts were almost 15 million per year up from an estimated 12.7 million in 2014.

“In recognition of the increasing demand for primary care services, my Department has continued to invest in our GP workforce and has increased the number of GP trainees by over 70% from 2015 levels. Work is underway on a review of GP trainee places to ensure we have the workforce in Primary Care we need going forward.

“Whilst this work is ongoing, I recently announced that my Department would be increasing of the number of GP training places for 2022/23 by 10, bringing the total number in Northern Ireland to an all-time high of 121 training places this year. This will help stabilise our GP workforce and ensure it is sustainable for the future. Any future increases will be informed by completion of the review and subject to the availability of funding.

“It is important to note however that the increase in demand for primary care services cannot be met solely by increasing the number of GPs. Rather this is part of a wider programme of work to help improve patient access to services in primary care. Other elements include the wider roll-out of primary care Multi-disciplinary Teams as well as the introduction of Advanced Nurse Practitioners and additional General Practice Nurses, all of which are making a difference to how services are delivered in primary care and contributing to improved patient outcomes.

“It is important to emphasise that GP practices are open and will continue to provide both face to face appointments and alternative consultation options for

patients as deemed clinically appropriate by GPs.

“The general practice telephone first consultations allow patients to seek timely medical advice from their GP for both routine and urgent problems. The GP determines the most appropriate approach to safely addressing the patient's needs using their clinical expertise. Where a face to face appointment is appropriate, that will be arranged. Alternatively, the GP may decide, based on their clinical assessment, that a telephone consultation is appropriate or that the patient should be signposted or directed to other relevant services. This approach helps the GP to appropriately manage, treat and support the large number of us who seek clinical support and advice from our primary care practitioners.

“I am aware that some patients are experiencing difficulties in relation to access to GP services and understand the frustration this can cause. My Department has established a Working Group to explore issues around access to GP services, including demand for services, limitations of infrastructure, and staffing and resourcing issues. The Working Group will also consider how technology can be better used to provide improved access in a standardised way across Northern Ireland.

“The Working Group will propose actions to be taken in the short, medium and long term to improve access for patients.

“It will be important that Primary Care continues to transform to meet growing patient demand. Technology and new ways of working will continue to play an important role alongside existing arrangements, such as face to face appointments, which will still be available to GPs to safely manage patient care.”

While for many patients, accessing their GP has been relatively easy, there is no doubt a vast disparity on the level of service being experienced across Northern Ireland.

Love Ballymena was contacted on Monday (27 June) by a member of the local community, frustrated by attempts to access his GP in a Ballymena-based medical practice.

“My local health centre’s service since lockdown has been nothing but appalling. If you don't phone the minute it opens, they just let the phone ring out - even for repeat prescriptions. This needs addressed because it is not fair on the community.

“My niece was two weeks old and going blue and our GP would not see her. We phoned our health visitor and was told to get an ambulance. My niece was admitted to hospital for the best part of a week.

“Service has really been affected from the covid pandemic, and anytime I get through the door there’s barely a person waiting, but they apparently are inundated with patients.”

The person shared a copy of their phone’s call log from Monday morning. After many calls, they were advised that no phone calls from the GP were available.