GP leaders in Northern Ireland will demand that the Government ringfence recurrent indemnity funding for all GPs, in a bid to attract more doctors.
Representatives from Northern Ireland’s LMCs met in Belfast for their annual conference on Saturday (16 November) to debate issues including funding, indemnity and practice sustainability.
They voted in favour of a motion demanding that the Department of Health provide new indemnity funding for all GPs, including salaried and locums, ‘in order to better attract and retain GPs in Northern Ireland’.
GPs in Northern Ireland are not yet covered by a state-backed scheme although GP leaders have lobbied for years for it to be instated.
The conference also instructed the BMA to have ‘a plan of action’ ready to be implemented ‘immediately’ should practices not receive the full 6% pay uplift recommended by the pay review body, as suggested by the health minister last week.
It also voted in favour of demanding an increase in funding for general practice to a ‘minimum’ of 10% of the health budget – up from 5.4% currently – and a motion asking that the Government fund GMS services per patient to ‘value more than that costed for an annual subscription to Petplan for a hamster’, initially not scheduled for debate, was also carried – despite Petplan getting in touch to specifically state they do not offer hamster cover.
An emergency motion demanding that practices are compensated ‘in full’ for the planned increase in National Insurance contributions (NICs) was also passed unanimously.
And another motion calling for a ballot on industrial action, following the ‘wholly unsatisfactory’ recent contract negotiations was carried as reference, meaning it should be considered by NI GPC when formulating policy.
However, LMC leaders voted down a motion calling for any future ‘major’ contractual changes to be sent to practices for ballot ‘prior to final agreement’.
NI GPC chair Dr Frances O’Hagan told the conference that indemnity is an ‘unresolved problem’ that affects only GPs in Northern Ireland.
She said: ‘We were promised a solution the previous minister and we were also promised a paper on a solution for here by calendar year end.
‘The minister has said that he is committed to that, and we want to see a solution implemented by 25 April, with additional funding that is ring fenced.’
She added that GP practices are now also ‘facing a problem’ caused by the chancellor’s budget and the increase in NICs.
‘GPs will have to find the money to pay the increased contributions, and it will cost practices tens of thousands of pounds,’ she told the conference.
‘This will lead to reductions in staffing, including salaried GPs, practice nurses, and admin staff, or even an increase in practice handbacks.
‘None of these options are good for GPs and none of these options are good for patient access. These costs must be either offset by a reversal of the decision by the chancellor, or with additional funding.’
She also said that the profession needs commitment from the Department of Health that the percentage of overall health budget allocated to general practice will increase.
Dr O’Hagan said: ‘We need a commitment for an incremental increase year on year going forward to give patients a service that they deserve from general practice.’
Northern Ireland’s GPs saw the full £38.9m worth of QOF funding repurposed for core services and indemnity cover this year.
As the final details of the 2024/25 contract – effective from 1 April – were agreed in May, the GPC said negotiations had concluded ‘successfully’ but that there was more to be done.
Dr O’Hagan told the conference: ‘We entered, in good faith, negotiations for the 24/25 GMS contract and the aim was to stabilise general practice, move funding into core and see an interim indemnity solution.
‘We did achieve the majority of this, but there were challenges including our pay uplift as recommended by DDRB. This must be paid in full.’
The motions debated at the conference
Indemnity
That conference instructs NIGPC to demand that DoH/SPPG ring fence recurrent and not repurposed indemnity funding for all GPs including salaried and locums in order to better attract and retain GPs in Northern Ireland. Carried unanimously
Funding
That conference believes that the current NHS GMS contract is making general practice sick and demands that DoH acts to increase funding for general practice to minimum of 10% of the health budget. Carried unanimously
That conference directs NIGPC to use all available means including the ICO or NIPSO to get aggregated information on the quantum of GMS monies that are taken to support Trust-run practices, and separately CIC-run practices. Carried unanimously
That conference demands that the process for funding of federations is reviewed and instructs NIGPC to work with DOH and SPPG to develop the necessary processes to ensure that direct funding can occur in the future. Carried unanimously
That conference demands that the Department of Health fund GMS services per patient in Northern Ireland to value more than that costed for an annual subscription to Petplan for a hamster!! Carried unanimously
That conference calls upon NIGPC to request that the Department of Health define the role, purpose and financial costing of running the SPPG and the impact that this organisation has made with respect to positive health outcomes in NI to date. Motion taken as reference
Practice sustainability
That conference notes with dismay the recent changes to the process for application to alter practice boundary and instructs NIGPC to;
- engage with SPPG to improve the process and improve flexibility in the timing of applications
- obtain legal opinion on a practice’s ability to unilaterally alter practice boundary and enforce this change without SPPG agreement. All carried
That conference instructs NIGPC to demand that SPPG has a forced list dispersal of patients removed as an option in the case of a contract hand back situation to prevent destabilisation of neighbouring practices and to ensure patient safety and staff welfare. Carried unanimously
That conference is appalled by the lack of funding for innovation in primary care compared to trusts. Carried unanimously
Patient safety
That conference directs NIGPC to demand that the DoH work with all relevant stakeholders to demand raised awareness and public messaging for caution in engagement with private health care bodies offering “Health MOTs”. Carried unanimously
SAI process
That conference directs NIGPC to make urgent representations to DoH and the CMO that any SAI process improvement must involve GPs at the design stage. Carried unanimously
GP registrars and training
That conference notes with dismay the delayed engagement from NI government with resident doctors in their contract negotiations, and demands that Department of Health and the Health Minister engage urgently with this branch of practice. Carried unanimously
That conference directs NIGPC to work with DoH to ensure there is an appropriate and backdated uplift for the funding for in hours and OOH GP trainers in line with DDRB recommendations. Carried unanimously
Emergency motions
This conference deplores any suggestion that the full DDRB uplift for 24/25 will not be paid to practices and instructs NIGPC to have a plan of action ready to be implemented immediately should this come to pass. Carried unanimously
This conference demands that practices are compensated in full for the planned increase in employers’ National Insurance contributions and instructs NIGPC to work with the other national GPCs to ensure that a centrally funded solution is delivered. Carried unanimously
General practice contract
That conference calls for any future proposed major contractual changes between DoH/SPPG and NIGPC to be sent to practices for ballot prior to final agreement. Motion lost
That conference calls for a ballot on IA, following the wholly unsatisfactory recent contract negotiations and the resultant breakdown in trust between the profession and DoH/ SPPG. Carried as reference
LMC governance
That conference calls on NIGPC to re-establish the Dom negs/ SPPG Forum meetings as previously constituted. Carried as reference
That conference calls on the four LMCs to work with the support of NIGPDF to finalise the job descriptions of LMC officers with consideration of inclusion of support in the event of maternity, paternity, adoption and sick leave. Carried
That conference calls on the four LMCs to work collaboratively with the support of NIGPDF to draft a collective social media policy around social media contributions by LMC officers when giving advice to GP colleagues. Carried as reference
That conference instructs NIGPC to develop a standardised form for claims for payment for GP attendance at meetings that;
- States the minimum rate of payment required for GP attendance per half day session regardless of employment status
- States the rate of travel expense to be paid in line with BMA policy
- Must be sent to and agreed with the requesting body before requesting GP attendance at meetings via committee
- Is shared with LMCs for use in local engagements with trusts and other bodies requesting GP representation. Carried unanimously
Primary and secondary care interface
That conference notes with some caution the introduction of advice and discharge as a mechanism for trust colleagues to triage referral and directs NIGPC to engage with Department and Trusts to rapidly produce regional standards on how this should operate. Carried
That conference notes with concern the increasing use of ECHO services and virtual clinics and instructs NIGPC to engage with DoH, SPPG and trusts to ensure that GP time is appropriately funded for taking part in these processes. Timed out
Source: BMA NI
