As General Practice approaches winter…

As we approach the end of the summer, our thoughts are now inevitably turning to the winter ahead. This year will likely be very challenging for the NHS and doctors working to care for the people of Scotland. We are living with Covid19 and as lockdown eases, we are seeing some signs of increasing cases. We all need to continue to stay vigilant and do all we can to reduce the risk of a second wave. There are two elements ahead of winter I want to update you on in this blog.

First, we know that as the colder months appear the usual respiratory illnesses will present as coughs and wheezes and be difficult to distinguish from Covid, so they must be regarded as such until testing proves otherwise.

That’s why we are proposing to the Scottish Government that the Covid Community Pathway including the Covid Assessment Centres needs to be up-powered and resourced to become Respiratory Assessment Centres which will allow continued streaming of possible Covid cases away from General Practice and A/E, reducing the risk of transmission and protecting delivery of non-Covid patient services. We are working closely with the RCGP Scotland on this and will keep you updated. Equally we have signalled that this must be the priority, ahead of any proposals around scheduling of unscheduled care, which you may have seen in the press and that we have concerns over.

Secondly, on winter preparations, of course part of the planning and public health protection will come from the Influenza Vaccine programme which this year includes more people than ever before with new groups and an extension of the age groups, potentially down to age 50 and above. I have said from early on this major challenge requires an ‘all hands-on deck’ response from the NHS with general practice playing our part, so I very much welcomed that the Scottish Government agreed that due to the size of the task it requires to be led by Health Boards, as only they have the power to redirect workforce.

Recently we concluded an agreement for the initial contribution from general practice to this programme. In exchange for income stability for this DES, previous activity will be converted into clinician time that practices will make available to the Board. Practices will also provide an agreed number of opportunistic vaccinations to patients who are being seen in the surgery for other reasons. This mechanism will help to maintain GP commitment to the programme and is intended to allow us to contribute to this essential programme without compromising our core capacity to see people who are acutely or chronically unwell. Practices will continue to assist with identifying patients, coding and can offer their experience in helping the local delivery systems. I think this is a wise and fair arrangement and I would ask and encourage every practice in Scotland to play its part.

My only regret is that we did not complete this agreement a few weeks back because I know that due to planning delays, a number of local areas have worked hard on developing their own arrangements. As a result, this national arrangement is intended as a backstop for general practice where plans are not in place. So, if local systems and in particular LMCs are happy with their arrangement in their area, then of course they can go ahead with those agreements.

Moving on from winter, and looking at more general issues, it was good to see the Scottish Government accept the DDRB recommendation of a 2.8% uplift for GPs, including £4M for population rise, overall this increases the GP contract value by £25M. Included within that there will be a 2.95% increase for practice staff to match agenda for change uplift – SGPC encourage and expect practices to use this to deliver a pay increase to their staff, so I would urge you all to do exactly that. The uplift is backdated to April and we have been promised will be paid at the end of September, and then will be paid at their uplifted rate from October.

I want to finish by paying tribute again to the way you have responded, as a profession to the challenges of recent times. I know people across Scotland are incredibly grateful. Equally I know that returning workloads, and the approach of winter while Covid remains a threat is a daunting prospect. While I can’t pretend this won’t be really challenging, I can assure you that SGPC are working hard to do what we can to help you through. Equally, the BMA’s support services are there for you round the clock as always, so please do use them if you need them. We absolutely are here to do all we can to help you as individuals, and help you care for the people of Scotland.

Dr Andrew Buist, chair of SGPC

Photo credited to Gordon Terris/Herald and Times Group

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