Maximising efficiency in general practice could save €100m, report finds

Up to €100 million in savings could be generated if Ireland's medical general practices were more efficient, a spending review by the Department of Public Expenditure and Reform has suggested.

In particular, nurses in GPs’ practices should carry out triage examinations and routine procedures, rather than leaving that work to doctors.

The spending review paper was published by the Government as part of the budget on the eve of the resumption of talks between GPs and health service management on a new contract.

A new GP contract will be a key element in the delivery of the Sláintecare health reform programme.

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The spending review said there was very little available evidence on the overall efficiency of Irish primary care and general practice in Ireland and more work in this area was necessary. However it argued that some clear examples could be identified of areas where the efficiency of Irish general practice could be improved.

“Within the practice itself, there appears to be scope for efficiency improvements in terms of the time GPs spend not consulting patients and the time spent conducting consultations which do not necessarily require a medical practitioner (eg, certification).”

“ Greater use of practice nurses for triage and routine activities as well as other practice support staff would appear to be a key part of a move in this direction and the effectiveness of this approach in turn depends on increased practice sizes. The most obvious and substantial areas where changes in general practice has the potential to increase value for money for Government expenditure is through its interaction with other forms of health expenditure including drug prescription and gatekeeping for the acute healthcare sector.”

The review said that research published in 2018 estimated a potential 15.9 per cent reduction in GP costs if the proportionate use of nursing staff in general practice in Ireland was increased to the rate in Northern Ireland. It said the OECD had also supported the policy of increasing the use of practice nurses in GP practices

The report said that greater efficiency could result in potential savings of €75 million-€100 million and that this money could be used to deliver further services.