My hopes for the future of general practice in Northern Ireland

RCGPNI invited all medical students in Northern Ireland to submit a 500-word essay detailing their 'Hopes for the future of general practice in Northern Ireland'. 

Professor Helen Reid from Queen's University and Dr Sian-Lee Ewan from Ulster University kindly graded all entries. Their combined marks showed a clear winner: Kieran Keenan (Queen's University) with joint second places: Amy Parke (Ulster University) and Conor O'Brien (Queen's University). 

Winning RCGPNI essay by Kieran Keenan

“Practice closure triggers stand-off as GPs refuse to accept list dispersal.” ¹

“GP federation refuses to take on 2,300 patients from closing neighbouring practice.” ²

A Google search of ‘GP Northern Ireland’ sums up the current strain and despondent atmosphere surrounding GP at the present. I feel we’ve become too habituated to the backdrop of these headlines concerning GP. Disgruntled members of a local community within Fermanagh went as far as brandishing the local GP with posters stating, “Public Health NOT Private Profit”, acting as a temperature gauge for the current mood amongst some. 

When I went to hatch ideas for this essay, I initially decided to add my thoughts on the options to keep general practice viable. The pros/cons of the centralisation of GP practices and whether a small rural GP is still economically viable was tempting to become the cornerstone of this piece. 

"My hope for general practice is a lot simpler. I simply hope that it has a future."

Alternatively, my hopes for GP were going to a thought piece regarding how to make GP more attractive to newly qualified Dr’s such as financial incentives, training flexibility or a push for specialist training to become the cultural norm in practices in order to further diversify the role.

I was going to hypothesise the potentials for the use AI within GP, using it as a tool to streamline patient triage whilst mitigating the risk of data breaches. However, I’ll let those more verse with economics or aware of the daily advancement of AI to add further debate to these points.

My hopes for the future of general practice 

My hope for general practice is a lot simpler. I simply hope that it has a future. Instead, I’ll indulge myself in recounting an anecdote from 2004. For those unaware of GAA sport, this was the golden era for the Fermanagh team reaching their only semi-final in the all-Ireland Gaelic championship. When our class had to choose one of the players to add to the wall art collection, whilst the majority argued over the merits of the corner forwards or the wingbacks, I opted to draw my GP/ Fermanagh team doctor Dr Tom Kiernan, briefcase and all.

Although that anecdote sounds more suited to answering the dreaded “so why do you want to study medicine?” it also outlines why I’ve an instilled defensive nature of general practice and emphasises the importance of the community GP for me growing up. My hopes that general practice is once more valued and synonymous with being the cornerstone and meeting the needs of the community and not being used to exemplify current failures of care.

To get there we must reduce the stresses on GP. We simply need economic investment in all aspects of staffing and infrastructure improvement. We need to make the IT systems more efficient in areas such as booking appointments and the interface between primary and secondary care. We need to enhance counselling services within the community. We need a better collaboration with community pharmacy, to reduce appointments involving self-limiting illness.

We need to hope that there is a future for general practice and unlike the 2024 Fermanagh Team, won’t fall short of its goal.

References

1. Bostock N. Practice closure triggers stand-off as GPS refuse to accept list dispersal [Internet]. GP; 2024 [cited 2024 Oct 28].
2. Anna C. Pulse Today, GP federation refuses to take on 2,300 patients from closing neighbouring practice [Internet]. 2024 Oct 16 [cited 2024 Nov 1]. 

Congratulations to the following essays in joint-second place

• My hopes for the future of general practice - Conor O'Brien (PDF file, 94 KB)
• My hopes for the future of general practice - Amy Parke (PDF file, 79 KB)