Northern Ireland news

GP out-of-hours service suspended in Belfast for first time due to staff shortages - with patients redirected to hospital 'urgent care' centres

'Urgent' patients unable to access out-of-hours GP services last weekend were told to go to the urgent care centre at the Royal Victoria Hospital, which is located close to the A&E department Pic Mal McCann.
Seanín Graham

CHRONIC GP shortages led to the suspension of an out-of-hours doctors service at the weekend - with patients instead told to go to hospital 'urgent care' units.

Belfast GP 'Beldoc' cover for the north and west of the city was unable to operate between noon and 6pm on both Saturday and Sunday, in what is understood to be a first for the Crumlin Road based service.

Severely reduced staffing also led to the suspension of out-of-hours GP care at the Knockbreda Centre on Sunday between 6pm and midnight for patients living in south and east Belfast.

There have been problems in attracting GPs to cover night-time, weekend and holiday rotas despite pay rates of up to £100 per hour.

Concerns have been raised about the impact of patients unable to access GP care and going to hospital A&E departments as an alternative.

A&E units across the north last week came under huge pressure resulting in long delays, trolley waits and pleas from health chiefs to only attend in an emergency.

Some patients have reported making more than 50 telephone calls to get through to their GP during daytime hours, due to the service changing to a 'triage' system at the beginning of the pandemic and not dealing with as many face-to-face appointments.

Belfast health trust confirmed the suspended out-of-hours GP service at the weekend, adding that those patients in need of "urgent care" were "advised to make contact with the urgent care centre at the Royal Victoria Hospital (RVH)".

The RVH urgent care centre has been running for over six months. It was set up to triage those patients who would have normally attended A&E with urgent but "not life-threatening" illness or injuries

- and who still may be transferred there for emergency care following assessment.

The centre, which is located close to the Royal's main A&E, is not run on a 24-hour basis. It is staffed by staffed by hospital doctors, GPs and nurses.

A trust spokesman added: "Those (contacting GP out-of-hours last weekend) experiencing a medical emergency were asked to dial 999 and non-urgent patients were asked to contact their GP on Monday morning.

"Alternative support is currently provided by allied health professionals and there are plans to expand this further."

With many GPs working in Belfast practices now heading for retirement, one doctor said the "writing is on the wall' for out-of-hours due to workforce changes.

"No matter how much money you offer people it will never be enough," Belfast GP Dr Michael McKenna, who once did shifts for Beldcoc, said.

"They're just too busy working in other places. Daytime GPs like myself are working from 8am to 7pm so have no desire to do extra over and above.

"And even though there's an official increase in the number of GPs , the workforce makeup is completely changing with more doctors working part-time.

"Around 75 per cent of the GP workforce between the ages 25 and 39 are female."

He added: "This lack of out-of-hours cover has been a bigger problem in more rural area but it was always going to happen in Belfast - where a certain proportion of the workforce were older and are now retiring.

"You're losing that experienced body of doctors who are coming up to 65. Government decisions that were made over the years to not implement three workforce reviews are coming home to roost."

The Belfast trust confirmed that 150 GPs have applied to work on a "sessional basis" at the out-of-hours service. Of this, 14 medics are salaried to work a set number of hours per month.

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