Is Northern Ireland’s primary care system on the verge of collapse?

For some GPs in Northern Ireland, it feels as though a sword of Damocles is hanging over their practice. In the past 12 months a total of 14 practices have faced possible closure.

“It is pretty dire,” says Donna Mace, a GP and senior partner at Aberfoyle Medical Practice in Derry. “We’re struggling because we’ve lost GPs over the past couple of years.”

The GP workforce crisis in Northern Ireland has been deepening for a long time. A BMA survey of practices in 2016 found that three quarters (74%) of them were struggling,1 in part because of difficulties recruiting doctors. One in 10 were “barely coping” at that time.

The Northern Ireland Department of Health (DoH) says that the number of GPs in NI increased by 9% between 2014 and 2022—however, a spokesperson for the BMA says figures from the Northern Ireland Medical and Dental Training Agency suggest a reduction in GP whole time equivalent of around 8%. The number of whole time equivalent GPs in NI has fallen by 136 since 2015, according to the BMA.

Looming retirements are unlikely to help: in England, 23% of GPs are over 55;2 in parts of Northern Ireland, this figure is as high as 33%, says Alan Stout, chair of the BMA’s Northern Ireland general practitioners committee.

According to the DoH, between 2014 and 2022 there was a 9% decrease in the number of GP practices, because of closures or mergers—as in England, where the number of GP practices is also declining.3 The Royal College of General Practitioners Northern Ireland (RCGPNI) …