A Future Together – Building a Better GP and Primary Care Service

Over 6,000 people provided feedback making this one of the largest engagement initiatives undertaken by the HSE

Overall 90% of patients in the consumer studies were satisfied with their last GP visit

The traditional model of hospital-dominated care is becoming unaffordable and indeed inappropriate for modern societies to provide a more patient-centred primary care service for patients and the healthcare system

Minister for Health Simon Harris will today, Monday 13th November, launch a report ‘A Future Together – Building a better GP and Primary Care Service’.  This report will inform the development and planning of the new GP contract and will help the thinking required to provide a more patient-centred primary care service for patients and the healthcare system. The report was commissioned by the HSE’s Primary Care Division and was conducted by a team from Trinity College Dublin, led by Professor Tom O’Dowd, Emeritus Professor of General Practice who is also a practicing General Practitioner.  

The key objectives of this report were; to conduct an international review of how primary care operates internationally with a focus on general practice; to carry out consumer research to provide an understanding of the patient experience of GP services and patient priorities, and finally; to do targeted qualitative interviews to get the views and insights of key individuals working in the wider healthcare system.  The report, presents a summary of the findings of an extensive stakeholder engagement process undertaken and an international review of the place of GP services. The report supports the shift to patient-centred primary care services in Ireland. 

The traditional model of hospital-dominated care is becoming unaffordable and, indeed, inappropriate for modern societies. Specialist hospital care commands significantly more resources and personnel than generalist care in the community. This is evident in Ireland from the proportion of the health budget devoted to general practice at 4.5%.  

Primary research was undertaken by Coyne Research and is provided in The ‘Research and Engagement Overview – Building a Better GP and Primary Care Service’ report.  A number of stakeholder engagements were carried out between October 2016 and May 2017.  The purpose of these engagements was to understand ‘what matters most’ to those who use, and those who provide GP services in order to learn what would be the optimal future GP and Primary Care service in Ireland.  Over 6,000 people provided feedback making this one of the largest engagement initiatives undertaken by the HSE.  The breadth and depth of these engagements has enabled the development of a suite of meaningful outputs, including a comprehensive final report which will inform the negotiation of a new GP contract and help to build a better GP and Primary Care Service. 

This report has provided the HSE with a deeper understanding of consumer satisfaction levels, the priorities and concerns of current and future GPs, and the perspectives of a range of professionals working within and or close to the Primary Care field. Collectively these inputs have provided valuable insight into how GPs can contribute to an enhanced Primary Care service and identified key areas for consideration and discussion.  A number of themes were explored at various stages throughout the process to ensure that a consistent approach was taken to analyse the data and included: quality, access, cost and range of services.

Launching today’s report Minister Simon Harris said: "This report is a very important piece of work which will help inform and shape our future decisions in the area of primary care. The development of primary care is central to the Government's healthcare plans and is in line with Sláintecare. The provision of a primary care fund in Budget 2018 demonstrates this commitment, as does the fact that we now plan multiannual funding for primary care.

In relation to the GP contract I would like to see agreement reached with GP representatives in the coming months on significant service developments that can be introduced during 2018. This will be the start of a multi-annual change process that will enhance the role of primary care as the foundation of a more accessible and effective health service."

Welcoming the publication of today’s report, HSE Director General Tony O’Brien said, “This report, ‘Building a Better GP and Primary Care Service’, contributes to the whole-of-society discussion on the future of our health services which I spoke about during the publication of the Sláintecare Report.  The key message from this report is that, only through the appropriate development and expansion of the capacity of general practice in Ireland, can we provide the type of healthcare system that our society now needs. It is in keeping with the work that the HSE is doing in reconfiguring our services away from a hospital centric system to a primary care led system and it lays the foundations for the changes that we will need to see in primary care and GP care over the next ten years. The report has important information that will enable us to plan together - those of us in the HSE, those of  us in the political system and our colleagues in general practice - to re-shape the way we provide primary care in a much more effective and fundamental way that is going to meet the needs of our changing population.”

Professor Tom O’Dowd, Emeritus Professor of General Practice, Trinity College Dublin said, “This is an extensive piece of research that places Ireland's primary care and general practice in an international context. It confirms that investment in primary care leads to better health outcomes at lower costs. There is an international and national consensus on the value of primary care as confirmed in the Sláintecare report. Freeing up GPs to spend more time on what they are trained to do requires orientating more nurses, physio, psychologists and social workers towards primary care. There is a lot of scope for investment in Irish primary care to enable it to play a full part in the healthcare system“.

HSE National Director of Primary Care John Hennessy, said, “This report reinforces the need for decisive change in Irish healthcare and provides useful pointers for service planning and targeted investment. Strengthening general practice and primary care to provide more enhanced services makes sense if we want to reduce the reliance on hospital care, improve the quality of services and patient satisfaction, and improve the performance of the overall health service. The research is clearly signalling that a strong primary care system is vital to the delivery of high-quality healthcare”.

Findings in the report include:

  • Overall 90% of patients in the consumer studies were satisfied with their last GP visit
  • 42% of the population has various levels of General Medical Services (GMS) coverage
  • Ireland has 6.26 GPs per 10,000 population, broadly similar to Denmark, Germany and the Netherlands but significantly lower than Scotland
  • Countries that are rated highly on measures, like access and services, have higher numbers of practice based staff – Ireland has the lowest rate of practice based staff ratio of the countries studied
  • Access to diagnostics, in particular radiology is an ongoing issue for GPs
  • GPs in training not interested in single-handed practice
  • Practice nurses were highly rated in the consumer surveys and are central to delivering high-quality care and ensuring continuity of care

  • Pharmacists see themselves as being able to share some aspects of chronic disease management with GPs
  • An increasing interest among allied health professionals (AHPs) in playing a part in caring for patients in primary care.

Research was conducted by Coyne Research on behalf of the HSE and findings are presented in “Research Findings from Service Users and Providers”.

Further information and copies of the reports are available to view here.

Last updated on: 13 / 11 / 2017