Table 1. Open in new tab Structure of...

Table 1.

Structure of general practice in Ireland.

• Most GPs work in urban or mixed urban and rural areas, with fewer GPs choosing to work in more remote areas of Ireland.¹⁹

• The majority of GPs in Ireland as of 2015 (82%) work in group practices (i.e. practices with ≥2 GPs), with fewer GPs choosing to work as single-handed GPs.¹⁹

• Ireland has seen an increase in the number of GPs working in primary care centres; as of 2015, approximately 10% of GPs work in primary care centres.¹ These are purpose-built buildings that house several health and social care services from 1 site (e.g. GP, public health nurse, occupational therapy, physiotherapy, and a range of other services).²⁰

• Pharmacists do not routinely work in general practices in Ireland, with the exception of a handful of practices who employ a pharmacist privately (true number unknown).

• GPs can be divided into 2 groups in Ireland: those in private practice alone, and those in private practice who are also participating in the GMS scheme. As of 2015, 89% of GPs were participating in the GMS scheme.¹⁹

• The GMS scheme is a means/income-tested state-run programme that provides healthcare to approximately one-third of the population of Ireland.²¹ Those eligible for the GMS scheme are issued a medical card or a GP visit card by the state.

• All children under 6 years of age living in Ireland are eligible for a GP visit card.

• GMS-eligible patients are entitled to free GP consultations, while the remainder of the population—who are considered “private patients”—must pay the full cost of each consultation.

• GMS GPs are remunerated by the state through the Primary Care Reimbursement Services (PCRS) in several ways²²:
◦ Capitation—payments are received monthly from the PCRS based on the number of patients the practice cares for and their age profile.
◦ Special type consultations—are claimed by GPs provided to patients that are not included in the capitation agreement with the PCRS (e.g. out-of-hours services).
◦ Allowances and subsidies—e.g. locum payment contributions or indemnity allowance.

• GPs can also claim additional reimbursement through the Structured Chronic Disease Prevention & Management Programme, which has 3 components²²:
◦ Opportunistic Case Finding (OCF)—aims to identify those with an undiagnosed chronic disease or at high risk of developing a chronic disease.
◦ Prevention Programme (PP)—focusses on preventing disease in those at high risk of cardiovascular disease and/or diabetes.
◦ Chronic Disease Management (CDM)—this programme consists of 2 reviews per year for patients with certain chronic disease (e.g. atrial fibrillation and diabetes).

• Most GPs work in urban or mixed urban and rural areas, with fewer GPs choosing to work in more remote areas of Ireland.¹⁹

• The majority of GPs in Ireland as of 2015 (82%) work in group practices (i.e. practices with ≥2 GPs), with fewer GPs choosing to work as single-handed GPs.¹⁹

• Pharmacists do not routinely work in general practices in Ireland, with the exception of a handful of practices who employ a pharmacist privately (true number unknown).

• All children under 6 years of age living in Ireland are eligible for a GP visit card.

• GMS-eligible patients are entitled to free GP consultations, while the remainder of the population—who are considered “private patients”—must pay the full cost of each consultation.

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