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Number of whole-time GPs in Scotland falls

Doubling of practices with a vacancy in 2 years, to 1 in 5 – many vacancies are long-term

Louise Prime

Tuesday, 14 June 2016

The number of whole-time equivalent (WTE) GPs in Scotland has fallen over the past two years and the proportion of practices with a GP vacancy has doubled over the same period, and has now reached one in five, show the latest official statistics. GP leaders have warned that the situation is unsustainable, and that general practice might not survive without significant funding and action to address increasing GP workload in Scotland, and problems with recruitment and retention.

The Information Services Division (ISD) this morning published results from its 2015 National Primary Care Workforce Survey. Its report revealed that although there has been little change in the overall estimated number of GPs since the last survey in 2013, the WTE has fallen by 2% – which, ISD pointed out, has occurred against a background of increasing demand for GP services, because of an ageing population and a “continued drive to shift from hospital to primary care”.

The 2015 ISD survey showed that not only has the number of GP vacancies increased since 2013, but also that a large proportion of these vacancies had remained unfilled for at least 6 months.

The number of WTE nurses and health care support workers has, in contrast, increased over this survey period. But over a third of GPs (and nearly half of male GPs), and more than a third of registered nurses in general practice, are aged 50 years or more.

The survey also included worrying figures on GP out-of-hours (OOH) services. It found that they rely on a relatively small number of GPs carrying out a notable proportion of hours worked; and that services regularly have to extend shifts, or ask nurses to cover GP shifts or vice versa, or offer additional financial incentives, to ensure that shifts are filled.

ISD reported that:

  • The WTE of GPs working in practices fell by 2% between 2013 and 2015 (from 3,735 to 3,645).
  • The WTE of registered nurses employed by general practice rose by 2% (from 1,420 to 1,455) and of Health Care Support Workers by 23% (from 300 to 365).
  • One in five practices reported having a GP vacancy at 31 August 2015, twice as many as in 2013. Half of the vacancies reported had been vacant for over 6 months. Only 5% of practices had a nurse vacancy.
  • More than a third of GPs working in Scottish general practice are over 50 (47% of male GPs but only 29% of female GPs); 53% of nurses are over 50.
  • 2,228 GPs were reported as working within OOH services; but of these, 6% worked an average of 20+ hours per week, accounting for 35% of the total GP hours worked.
  • All NHS Boards, except Shetland, said they’d had to take actions due to being unable to fill all GP OOH service shifts as planned, and nine reported that they’d had to do so at least weekly.

Chair of the BMA’s Scottish GP Committee Dr Alan McDevitt, who is 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.”

He warned: “General practice is facing some of its toughest challenges, with workload and patient demand at unprecedented levels. Our members across the country are telling us of the rising pressure they are facing and the difficulties they are having trying to recruit to vacant posts. This is simply not sustainable.

“Without commitment to substantial new funding and staff, the general practice we all need and value, may not survive.”

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