Out of Hours Service on Brink of Collapse in Northern Ireland

Out-of-hours services in Northern Ireland are on the verge of collapse, according to testimony from Irish GPs.

Doctors in the nations state that it is common for individual GPs to cover populations of 370,000 single-handedly.

The Northern Irish branch of the Royal College of General Practitioners noted that the South and West are being hit the hardest.

Indeed, evidence suggests that the problem is so rarefied in these regions that institutions are threatened with being forced to close completely.

Dr Frances O’Hagan, chair of Southern LMC, described the service in the South as ‘broken’.

“We have been limping along but I would say it is now broken in the South. There is a problem with chronic understaffing but it has come to a real head in the past few weeks. Having only one doctor on call used to be rare but is coming the norm. If I do more than two shifts a month my indemnity rockets so I can’t just do a couple of hours here and there to help out”.

While this issue is particularly severe in Northern Ireland, similar problems are beginning to emerge in England.

It was recently reported that an out of hours provider in Doncaster responsible for 300,000 patients had been running night shifts without any GPs available for the rota.

RCGP NI chair Dr John O’Kelly suggested that understaffing and underinvestment had taken its toll on the Northern Irish health service.

“It’s not surprising out of hours is in trouble and it has a knock on effect on the whole of the health service. Young GPs are quite rightly worried about doing out-of-hours shifts over fears it is just not safe. Sat on the minister’s desk right now is a report with recommendations which would solve these problems. The College has called on them to fully resource GP services.”

A spokesperson for the Southern Health and Social Care Trust acknowledged that it had been a significant challenge to ensure there are enough GPs to cover the 440 sessions a month for some time.

“We recognise the service is under pressure and at times during the quieter 12pm – 8am period, there is only one doctor on cover but we also have nurses available to provide triage. The Trust is working with local GPs, the Southern Local Medical Committee and the Health and Social Care Board to help ensure the GPs who currently work in the service continue to do so and to encourage more GPs to work in the service”.


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