To ask the Minister of Health (i) for his assessment of the changes in the workforce of General Practitioners over the last ten years; (ii) to detail the impact that these changes have in meeting the demand within primary care; and (iii) to detail his Department’s workforce planning to take into account changes over the last 10 years.

Primary care services are a cornerstone of our health and social care provision. Unfortunately, even prior to the COVID-19 pandemic, primary care services were already coming under increasing pressure. It remains my assessment that GP-led services cannot continue to meet the rising demand and expectations without urgent action to address the pressures facing the service. To do this, means that we have to focus on both the GP workforce and on developing new ways of working that were already being implemented but which have accelerated during the pandemic.

Focussing on the workforce of General Practitioners specifically, recent figures from the Business Services Organisation show that at March 2022, there were 1,419 GPs working in Northern Ireland. It should be noted, however, that not all GPs work full-time hours so changes in headcount may not reflect the change in full time equivalent GPs. This is against a backdrop of rising demand for GP services, compounded by the ongoing pressures created by COVID-19. Further details on the specific demographics of the GP workforce including its evolving gender and age profile are also set out in the report from BSO which is available at: FPS - General Medical Statistics Annual Report (hscni.net)

Our workforce planning approach has sought to take account of the need to ensure that we have a GP workforce that is supported, motivated and sustainable and that continues to provide quality care to patients.

The General Practitioner Medical Workforce Planning Group Final Report – June 2015 considered demand for GP services, comparison of GP medical workforces, GP training, workload and workforce trends. It recommended a phased increase in GP training places to 111. The Department achieved this expansion in 2019/20, an increase of 71% from 2015 levels. Work is underway on a review of GP trainee places with a working group established to explore issues relating to the GP workforce to ensure we have the workforce in Primary Care we need going forward. Whilst its work is still ongoing, I have accepted the working group’s recommendation of an immediate increase of 10 additional GP training places as an interim measure for the 2022/23 academic year bringing the total number in Northern Ireland to an all-time high of 121 training places this year. Any future increases will be informed by completion of the work of the working group and subject to the availability of funding.

In addition to the work outlined above, a number of support schemes are also in place. The GP Induction and Refresher Scheme provides an opportunity for GPs who meet the required criteria to safely return to general practice following a career break or time spent working abroad. It also supports the safe introduction of overseas GPs and provides support to GPs returning to or entering clinical practice in Northern Ireland. Similarly, the GP Retention Scheme is designed to assist in the retention of GPs who may be considering leaving or reducing their sessional commitment to general practice.

However, our workforce planning approach has also recognised that the increase in demand for GP-led services cannot be met solely by increasing the number of GPs. This is only one element of a wider programme of work to help improve the provision of care for patients.

Broadening skills mix has meant the development of new roles, such as Advanced Nurse Practitioners and General Practice Pharmacists and the roll out of our Primary Care Multi-disciplinary Teams (MDT) model. This model has introduced new social work, mental health, physiotherapy and social work roles into general practice, complemented by increased levels of district nursing and health visiting staff. This model, which is complete or in developed in 7 of the 17 GP Federations in Northern Ireland – Down, Derry, West Belfast, Causeway, Newry & District, North Down and Ards Federations, aims to move from a system of treating illness to holistically supporting positive physical and mental health, and social wellbeing.

In seeking to meet increasing demand, primary care is also building on new and innovative ways of working, including making greater use of technology. This includes the use of general practice telephone first consultations which allow practices to maintain the majority of GP-led services and enable GPs to appropriately manage, treat and support more patients on the same day.