Working as GP in Scotland is very often extremely tough right now. Indeed, it has been for some time.
And, to be honest, that isn’t being helped by the actions of the Scottish Government.
Indeed, it’s not hard to form a list of areas where the support we need hasn’t been forthcoming or worse, has been withdrawn. One recent example is the threat to practices posed by the pausing of sustainability loans, something we have campaigned strongly against. You may have seen the press coverage of our survey which highlighted some 30 practices are at risk of collapsing as a result.
We are also still waiting to hear whether the Scottish Government will cover the increase in pension employer contributions for practices – again something I know is weighing heavily on minds because of the direct adverse impact it would have on practice finance if not covered.
It feels like the rug is gradually being pulled from under our feet, starting from when the pandemic eased, just as we were all supposed to be recovering. All of it is contributing to pushing practices closer to the edge of what is sustainable and putting some practices beyond the point of recovery.
It is also no doubt contributing to people leaving the profession and the fall in whole time equivalent GPs which then further accelerates the mismatch we all suffer between capacity and demand.
We know that General Practice is the linchpin of healthcare in the community and that the only affordable sustainable healthcare system for Scotland will be one which has its focus on primary care and community health. Yet there is little sign that the Government understands, or has a solid plan to even shore things up, let alone put us on a path to a sustainable future which delivers on the full potential of General Practice.
In these circumstances, it might be tempting to disengage from official communications that come from the Scottish Government or national health boards. I have a lot of sympathy for that feeling, but there is one particular request that will be heading your way that I would urge you not to ignore.
NHS National Services Scotland are getting the annual GP Workforce Survey underway and from a BMA point of view, we would urge you to take the time to work with your practice managers and respond. That is because we need the evidence that this survey will provide to challenge statements and assertions made about progress and to ensure that the reality of the situation set out in this blog hits home to politicians either directly or indirectly through the media work we will do as a result.
This survey speaks to the fact that GP numbers are a long way from where they need to be. Take last year’s survey: the results when published, showed falling GP numbers on both headcount and crucially WTE. Looking at a longer term trend we were able to show that since 2013, the trained GP WTE workforce has fallen by 5.35% – a fall of 196.7 WTE.
Combining this with data of population growth and demographic change allows us to demonstrate the scale of the workload pressures we face in black and white and helps to illustrate the kind of challenges in meeting demand you tell us about every single day. We can immediately publicise them in the press – as we did in December last year to considerable coverage, which then gets the attention of the public and of course politicians. Beyond that we can use the figures consistently as we make our case with Government for them to reverse the kind of damaging funding decisions they have taken of late.
If completion rates of the survey fall it carries less credibility, and risks weakening our hand in future discussions with Ministers.
So, I would urge you to make sure your practice plays its part and returns its response to the survey. It will be live until Wednesday 31 July inclusive, which should hopefully provide sufficient time, even though I well know the pressures you are under. The good news is that if your practice did the survey last year, the data will be pre-populated from your previous entry, as pushed for by the BMA, so updating it should be relatively stress free. Your practices should have been sent details of how to complete it either from NSS or their health board and this time the collection is through an app that can be accessed on teams or via a web browser, rather than a clunky excel spreadsheet as in previous years. It should have gone to your Practice Manager’s NHS inbox rather than any generic address.
Hopefully that will help your practice get started and that you are able to respond. In the meantime, we will go on speaking up on your behalf, highlighting the challenges we face and the wider consequences we see of a continuing failure to protect and grow sustainable General Practice.
Dr Patricia Moultrie is Deputy Chair of BMA Scotland’s GP Committee
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