Debate contribution: GP Services: South Antrim

Debate contribution by Mr Mike Nesbitt on 10 February 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

10 February 2026

Type

Debate contribution (made as a minister)

Business

Adjournment

Heading

GP Services: South Antrim

Assembly identifier

Official Report component 5436018

Read the official Assembly record

Text

I thank Mrs Cameron and welcome the opportunity to outline my thoughts on primary care. Mrs Cameron mentioned the Public Accounts Committee's 'Report on Access to General Practice in Northern Ireland', and I welcomed the report. We have considered the findings and the recommendations in full, and we will now work in partnership with general practice, the representative bodies and patients and service users to address those recommendations. That said, a number of the recommendations in the Committee's report are being addressed in work that is already in train and is set out in my reset plan, which was published in July last year. I am aware of the enormous demands on general medical services (GMS) and the impact it has had on patients and general practitioners. In that context, I fully recognise the dedication and tremendous efforts of all GPs and practice staff in working to meet the needs of their patients. In South Antrim, there are 11 practices and 59 GPs, both partners and salaries, and they have a combined patient list of 85,000-plus patients. It is no small commitment. I assure you that my Department is committed to addressing the issues across Northern Ireland and to ensuring that patients will be able to access high-quality, sustainable GP services now and in the future. To help achieve that, my officials continue to take forward a wide range of work in the short and longer term with stakeholders across the system.

Regrettably, there have been 16 contract hand-backs since financial year 2023-24. There were 11 in that year and five in financial year 2024-25. However, no contracts have been handed back since last February. Mrs Cameron said that there was not the same level of hand-back in South Antrim as there had been elsewhere, but, in fact, there have been no hand-backs in South Antrim. Despite the pressures on general practice and the number of practices that have handed back contracts, we have been able to ensure that only one of those contract hand-backs resulted in practice closure.

I give way to the Member, but I have no confidence that this will have anything to do with South Antrim.

I am not aware of GP practices denying people access until March. I will make this more general point to the Member: we are now at a position at which, after a hiatus, negotiations on the 2026-27 contract can begin between the Department and the BMA General Practitioners Committee. That is absolutely critical. Every year's contract is important, but this year has to be a consequential year for health and social care delivery, because we have to shift left into the neighbourhood model. While that will include community pharmacies, as Mrs Cameron mentioned, ophthalmologists and dentists, GPs are its heart. We need them all, but, above all, we need GPs. I will not say anything that will be critical of something that you have stated and which is news to me, but I will take it away and ask officials to examine it. On short-term measures, the general practice improvement and crisis response team supports practices at risk. That has been important in providing stability, but more sustainable options are required in the longer term. I note that none of the 11 practices is receiving support from the crisis response team, never mind handing back contracts. We are also working with the GP federations to explore how they can play a role in the longer-term sustainability of general medical services. Over the past number of years, my Department has made available significant funding to help GPs meet the growing demand for primary care services and enable practices to improve their telephony systems and accessibility and increase staffing levels to ensure that telephony demand is managed effectively. A best practice guide, 'Making all Contacts Count', has also been developed and shared with all practices, supporting the management of patient demand and optimising workflow, with the aim of improving experience for patients and practices. My priority is always to ensure that patients, including those in South Antrim, can continue to access safe, high-quality, sustainable GP services when they need to. My desire has always been to work constructively with GPs to help achieve that outcome. I have stated many times that I regret that it was not possible to reach agreement on the GMS contract for the financial year 2025-26. My Department has remained engaged with GP representatives over the past year with a view to finding a way forward to re-establish normal relations and re-enter negotiations for 2026-27. I am pleased to say that we have made good progress on that recently, and I am optimistic that we will be able to re-engage in substantive contractual discussions in the coming weeks. The 2025-26 GMS contract included an additional investment of £9·5 million in general practice. I also made a ministerial direction in line with the recommendations of the pay review bodies, which the Executive have agreed. That has enabled my Department to implement the pay award for independent general medical practitioners in full in 2025-26. That was at a value of £11·7 million of additional investment. That payment is due to be made to GPs and their teams in the February pay run.

To help primary care to deliver and grow, it is critical that we train, develop, support and retain the GP workforce. My Department has funded initiatives to recruit and retain GPs. Training places are at an all-time high of 121, which is an increase of no less than 86% since 2015-16, and my officials are progressing work to project the number of GP training places required over the next five years. I hope that that answers, in some part at least, Members' questions about how we will supply our workforce, going forward. We are working with key stakeholders to increase the exposure of undergraduates to general practice. We are encouraging more GP trainees and ensuring that there are sufficient GP training practices to meet demand and support GPs in training. We have introduced other schemes to support the GP workforce, including the Attract, Recruit, Retain scheme, which is designed to support the recruitment of GPs in hard-to-recruit areas. Since that scheme was established, in January 2023, 110 GP practices have applied for and received approval in principle for funding under the scheme, and 70 practices have applied for and received final approval for payment in respect of a recruited GP. Members will be aware that, last year, my Department announced investment of £61 million over the next four years to support the wider roll-out of the primary care MDT model, which will provide access to a wider range of services for primary care and help to stabilise GP services. The multidisciplinary team model remains the key to stabilising and strengthening vital primary care services and ensuring that they can continue to provide high-quality care to our people, now and into the future. The MDT programme has significantly expanded the capacity of primary care since its introduction, with an additional 335,000 consultations provided in financial year 2024-25 alone. It is estimated that a full roll-out of the programme could provide around one million additional appointments in general practice settings. On 24 July last year, I published a plan for the completion of the primary care multidisciplinary team model across all areas of Northern Ireland. As we are mindful of the serious staffing and funding pressures facing Health, full roll-out of the programme will be taken forward in a two-phase approach over the next seven to eight years. The first phase is supported by £61 million from transformation funding. That will enable completion of the model in the seven existing MDT areas and expansion into five new GP federation areas, with a population of around 670,000, over the next four years up to the end of financial year 2028-29. The new areas to benefit from transformation funding during phase 1 will be north Belfast, the south-west — Fermanagh and west Tyrone — east Antrim, Craigavon, Dungannon and Armagh. Detailed local plans that determine the sequencing and timescale of investment in practices during phase 1 have been agreed, and funding for 2025-26 has been allocated accordingly. The south Antrim area, which is part of the Antrim and Ballymena GP Federation, will commence roll-out during phase 2, along with the east Belfast, south Belfast, Lisburn and Mid Ulster GP federations. Phase 2 will run for four years, from financial year 2029-2030, and that will see the MDT model completed in the remaining five GP federation areas. Lessons are being learned as further roll-out progresses, and, while phase 2 may seem some way off, I can assure you that, if it becomes possible to do more faster when it comes to that roll-out, that is exactly what will happen. In the interim, a number of practices in the south Antrim area recently received significant investment in their premises in advance of the MDT roll-out across the south-east Antrim locality. That will enable them to accommodate the additional staff associated with the roll-out. However, all practices in the South Antrim constituency already have access to a practice-based pharmacist. Looking to the future, we remain committed to working with GPs and their representative bodies to support primary care services with the aim of securing the long-term future of general practice over the coming years. However, it is important to bear in mind that any increase in the level of spend on primary care must be investment with a purpose, that purpose being to improve the sustainability of and access to services and to ensure that patients can expect the same high standards from their GP, no matter where they live. The focus of investment in general practice in the future should be on meeting the evidenced demand for services and transforming the way GP services are delivered. In my reset plan, I made a commitment to developing a neighbourhood model to deliver greater levels of care to our citizens in their local communities and as close to their front doors as possible. That model will see GPs and their federations, along with Community Pharmacy, voluntary and community organisations, trusts and independent providers working closely together to provide coordinated care to patients in their localities. It is an important enabler of my commitment to shift left. I hope that GP practices will play a decisive role in the ongoing development of the model and in its implementation. We are now working at pace to take that work forward in line with that commitment. To inform the early developmental work, I visited examples of how neighbourhoods can work within that model in England. We saw that GPs were at the heart of those models. There is very good reason for that. It is because GPs know their patients and their communities that they are so well placed to play that central role in the establishment of a model that will improve access to care and shift the focus from reactive treatment to proactive engagement. Over the past number of months, my officials and I have been engaging with GP colleagues as part of the design phase of that new neighbourhood model. I assure you that that will continue. What is clear is that building a neighbourhood model will require providers to work in new ways to deliver their services. The proposed model will be built around 17 integrated neighbourhood teams that act as provider alliances. They will operate with the trust and area integrated partnership boards at GP federation level, serving an average population of 115,000. Those integrated teams will know the populations that they serve and will work together as a team of teams. In doing so, they will lead and drive delivery on improving access and priorities for moving more care closer to home. They will work with smaller neighbourhoods within the footprint — the natural communities to which people feel that they belong. There are new ways of working, new ways of thinking, new partnerships and new approaches to service design. The potential is enormous. By building care around communities, we can improve outcomes, reduce pressure on hospitals and create a more sustainable system. I hope that Members will note the actions and initiatives that my Department is taking forward and will be reassured that I am committed to ensuring safe and equitable access to general medical services for all the people of South Antrim and Northern Ireland. As Mrs Cameron said, GPs are the lifeblood of our health and social care system. When it works well for them, it works well for everybody. That is my ultimate determination.

2,105 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 14:52 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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