GP contract deal welcomed as step towards stabilising struggling services

Last year, GP practices here were handing back their NHS contracts at a rate of more than one a month as they struggled to make ends meet, leaving parts of Northern Ireland without adequate access to a family doctor.

The new contract has been welcomed by Health Minister Robin Swann and the BMA’s Northern Ireland GP committee as an important step towards helping to stabilise services.

The Department said the deal will provide GPs with greater certainty over their income throughout the year, reduce the amount of red tape and associated costs, and provide dedicated funding to practices for the costs of their indemnity.

Despite major pressures on the health budget, the committee said it was able to secure £5m in funding for an indemnity solution for this year.

GPs are required to have indemnity for clinical negligence claims so that their patients can receive compensation if they are harmed by negligent care.

The indemnity system for GPs here is different from that in place in England and Wales.

The lack of a state-backed indemnity scheme in Northern Ireland has meant full-time GPs having to pay fees of up to around £10,000 a year.

With the health service in crisis, some GPs in Northern Ireland were last year sued by patients coming to harm on hospital waiting lists — even though GPs were not responsible for the crisis. The annual indemnity amount increases when a GP has had to make a claim having been sued by a patient. The changes have been agreed for 2024-2025, with the committee and the Department of Health agreeing to further work to overhaul the contract from 2025 onwards.

Commenting on the changes, lead negotiator Dr Alan Stout, chair of the BMA’s Northern Ireland committee, said: “When we entered negotiations we were clear that we had three aims; to simplify the contract, to ensure a fair uplift and to make significant progress on indemnity.

“We have managed to negotiate successfully in these key areas for this year, and we secured a commitment from the Department and SPPG (the Strategic Planning and Performance Group, formerly the Health and Social Care Board) to further review the contract for subsequent years.

“Equalising the indemnity provision for GPs in Northern Ireland was a ‘red line’ for the negotiators and we were able to secure £5m for this year to cover indemnity costs.

“This will be shared on a capitation basis among practices and will mean an average uplift of £15,900 per average practice and, to help with cash flow, this will be paid at the start of this financial year.

“We will continue to work with the Department to bring forward a longer-term indemnity solution that ensures we have parity with the rest of the UK.”

Health Minister Mr Swann said that “stabilising GP services is of crucial importance and I believe this contract is a step forward in that regard”.

But he added: “There is, of course, much more work to be done. Whilst the budget provided to me by the Executive does not allow me to make a substantial increase in the overall value of the contract, I am pleased that the agreement announced today makes significant progress against key aims identified by GPs in their negotiations, including provision of dedicated funding for their indemnity costs.

“I would pay tribute to the constructive and imaginative approach taken by NIGPC leadership throughout these negotiations.”