GP Practices are independent, small businesses, often operating from their own premises. They have a responsibility for employing their own staff including doctors, nurses, receptionists and healthcare assistants. The GP Practice works alongside other healthcare professionals such as district nurses, health visitors and social workers which are employed by Health and Social Care Trusts.
The contract between the Health and Social Care Board (HSCB) and GPs is available on the Department of Health website.
GPs are not directly employed by the HSC but are contracted by it to provide medical services to their patients. The contract defines essential, additional, and enhanced services. The Board monitors GP practice performance to ensure that safe and high quality services are provided.
All GPs must provide ‘essential services’ to their patients. These are services required for the management of registered patients and temporary residents who are, or believe themselves to be ill, with conditions from which recovery is generally expected; terminally ill; or suffering from a chronic disease.
The contract states that these essential services are to be delivered in the manner determined by the practice in discussion with the patient. Thus the contract provides a high degree of autonomy for each GP practice to make arrangements to provide essential care in the most appropriate manner.
‘Additional services’ include cervical screening service, contraceptive services, vaccinations and immunisations, childhood vaccinations and immunisations, child health surveillance services, maternity medical services, and (some aspects of) minor surgery. While these services are defined separately in the GP contract, currently all GP practices provide them.
‘Enhanced services’ are other services that a GP practice agrees to provide which are beyond the scope of essential services. These include among many other examples services such as medication monitoring, elective care pathways, additional care for mild to moderate depression, urgent assessments for patients with serious mental illness, management of violent patients, enhanced care for adults with a learning disability, (a broader range of) minor surgery, dermatology photo-triage, substitute prescribing, proactive care for patients in nursing and residential homes, and phlebotomy (blood-taking) services for secondary care. Not all GP practices provide all enhanced services.
The HSCB provides funding to GP practices depending on the number and types of patients registered with them.
The annual report, which can be found on the Business Services Organisation website, contains high level summary information in relation to General Practitioners (GPs), GP Practices and Registered Patients including registration activity and payments processed by BSO towards the overall cost of GP Services in Northern Ireland.
This was a reduction of two compared to 2020 and a reduction of 29 (8%) since 2014
Of these, 58% were female and 42% were male, a notable shift in gender profile since 2014 (46% female, 54% male)
During 2020/21 there were almost 40,000 new patient registrations and approximately 40,000 patients deducted.
This was an average payment of £158 per registered patient.