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waitingroomJune 15 2016

The whole time equivalent (WTE) number of GPs working in practices declined 2% between 2013 and 2015, Scotland’s Primary Care Workforce Survey 2015 has revealed. One in five practices was reporting having a GP vacancy at August 31 2015, double the rate of vacancies two years earlier.

Data from 561 general practices, representing 58% of practices in Scotland, responded to the survey. responses indicated that GP numbers had fallen from 3,735 to 3,635. However, the survey said that the WTE of registered nurses employed in general practice increased 2%, up from 1,420 to 1,455, and the WTE of healthcare support workers increased 23%, from 300 to 365. Only 5% of practices reported having a nursing vacancy.

The ‘In hours’ survey has been published by the Information Services Division of NHS Scotland. It noted that “2,228 GPs were reported as working within GP Out of Hours services. However there was a large variation in the amount of time input to the services: 6% of GPs working in GP OoH services worked an average of 20+ hours per week which accounted for 35% of the total GP hours worked. The remaining GPs working in Out of Hours Services generally worked only a small number of hours each over the year.”

Commenting in the figures, the RCGP in Scotland said that since 2013 it has been consistent in calling for the share of NHS Scotland funding received by general practice “to be incrementally raised to 11%, to halt and reverse a decade of cuts. To date, funding has only been increased to wider primary care.”

Dr Miles Mack, Chair of RCGP Scotland, said that increasing funding to primary care was insufficient. “We must see urgent increased funding specifically to grassroots general practice services,” he said. “We now need even more GPs than we did this time last year, despite the years in which our public campaign has been illustrating the situation to Scottish Government and receiving significant public backing. It is frustrating and worrying that those warnings have not been heeded.

“We are concerned that the 100 extra GP training places promised in October 2015, to start this current year, have not come about and that we have yet to hear a timescale for their delivery. 20% of last year’s training places went unfilled.”

Medical students need to be persuaded that general practice is the most desirable career in medicine, said Dr Mack. “Being a GP is the most challenging, interesting and rewarding of jobs and it is a necessity to ensure it is recognised and allowed to flourish.

“NHS England has just announced that they are no longer ‘in denial’ at the state of the service, though that service already had a full 1% more share of funding than Scotland’s general practice receives. Funding there for general practice will rise to ‘over 10%’ of NHS England spending. The College has consistently laid out why the profession needs 11% in Scotland. We need to hear urgently that Scottish Government will see that investment replicated.”

The BMA has also raised its concerns about GP levels. Dr Alan McDevitt, Chair of the BMA’s Scottish GP Committee, and a practising GP in Clydebank, said: “GPs are choosing to leave the profession and those that remain are facing an increasingly unmanageable workload. Without significant funding invested specifically in general practice recruitment and retention, the situation will only get worse.

“We know that Scotland’s population is living longer and with that comes an increasing number of people with complex care needs. The Scottish Government aims to treat more people as close to home as possible, but unless general practice is supported, it will not be able to meet these growing needs.”

The Royal College of Nursing noted the contrast between the increase in nursing and care staff compared to the decline in GP numbers. In addition, advanced nurse practitioners will play a role.

“Developing the opportunities for nurses to take on these advanced roles within general practice and out of hours services needs robust workforce planning and education provision right across primary care settings, if Scotland is to have the right workforce, with the right skills in the right place for the future,” said RCN Associate Director Ellen Hudson.

“This survey shows significant pressures across the primary care workforce, even in nursing where numbers have increased ... it does underline why the RCN has been calling for a radical review of 24/7 primary care services that brings GPs, ANPs, nurses, pharmacists and other health professions, like physiotherapists, together to deliver high quality, sustainable services for patients. Investment in any one profession alone cannot solve the problems we are facing in primary care.”

Links:

ISD Scotland Primary Care Workforce Survey Scotland 2015

RCGP response

BMA response

RCN response

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