Even prior to Covid, Northern Ireland had some of the longest outpatient waiting lists in europe. Annual demand for elective services exceeded capacity by around 60,000 assessments and 35,000 treatments. In 2018 time the waiting time for vasectomies in secondary care was several years. some hospitals had nearly stopped offering procedures.The Bengoa Review identified that a long-term solution to better address the demand for elective care services was required in order to deliver sustainably shorter waiting times for patients. In an effort to do so, GP federations were commissioned to design and deliver a range of pathways (GP Elective Care Services) to manage patients more appropriately in primary care without the need to refer to secondary care. 5 services were developed.
- Primary Care Surgical Service
The ASPC (Association of Surgeons in Primary Care) helped train up approx. 10 or 11 GP's, all with previous surgical skills, as vasectomy surgeons, back in 2018. Their training was paid for through funding for Health Care Transformation.
Since 2018 and the introduction of Primary Care Vasectomy, about 7000 vasectomies have been undertaken in primary care in Northern Ireland.
Joe was one of those the ASPC trained vasectomists and became the Regional Clinical Lead for primary care vasectomy. Joe joined the ASPC Council as the Northern Ireland representative in 2019.
Joe has subsequently become an accredited Vasectomy Trainer in 2020, and has trained 10 new vasectomy surgeons in NIA, at present there are 14 surgeons offering vasectomies on the NHS over the entire region.
In 2023, Northern Ireland faced a funding shortfall, across all Government areas, with the Dept of Health budget being £470M less than estimated funding requirements.
In an effort to find £5M of savings, the funding for GP Elective Care Services has been slashed by 50%, with the vasectomy services being reduced by 66% in the 3rdquarter of 23/24 and then stopped altogether from December 2023. https://www.itv.com/news/utv/2023-07-28/gp-clinics-providing-elective-surgery-are-to-have-their-funding-cut-by-half
The four other services (Dermatology, MSK, Gynaecology, Primary Care Surgical Service) are still going, but at only 50% of previous level of activity.
Abortion services, only recently set up in N. Ireland, are not subject to these cuts in funding as they are a statutory service