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Scottish out-of-hours GP care under strain

‘Goodwill’ is ‘no way to run a service’

Jo Carlowe

Tuesday, 19 November 2013

A primary care workforce survey reveals widespread problems with GP cover for out-of-hours care in Scotland.

In its experimental report: ‘Primary Care Workforce Survey 2013’ published today, The Scottish Government’s Information Division (ISD) describes “difficulties in all the NHS Boards in staffing the required number of out-of-hours (OOH) shifts”.

It goes on to state: “In general the main issues revolved around providing GP cover at weekends, public holidays and other peak periods such as school holidays. However, there were also problems noted in filling later evening/overnight sessions during the week, cover for GP annual leave and PLT sessions.

“Boards often noted that they were reliant on good will and being able to persuade staff to fill shifts.”

The Royal College of Nursing (RCN) Scotland is calling for action “as a matter of priority to ensure patient safety, particularly at weekends and over public holidays”.

RCN Scotland Director Theresa Fyffe said: “This report acknowledges that there are difficulties in all NHS boards in staffing the required number of OOH shifts and Boards themselves often acknowledge that they are reliant on good will and being able to persuade staff to fill shifts. This is no way to run a service.” 

The RCN says the ISD report “paints a picture of a confused landscape across Scotland for the provision of GP OOH care”.

The ISD report shows variations between different health boards. For example it states that where non-clinical staff were involved in the provision of GP OOH services, they accounted for between 35% (Fife) and 61% (Dumfries & Galloway) of the total person-hours required.

Commenting on the report, a spokesperson for the British Medical Association Scotland, said: “The volume of work for GPs ‘in hours’ is now so intense and, along with the increasing intensity of work during out-of-hours shifts, means that many doctors are reluctant to work extra hours, particularly when many GP surgeries are now opening earlier in the morning and later in the evening.

“Out-of-hours urgent care is a vital part of the NHS care patients need, but the solution is not singularly that of GPs doing more. We need to keep looking at how out-of-hours care across the NHS in Scotland is working, along with social care services, to make sure that we are providing the right support and care that patients need, in the right place.

“The rising demand for urgent GP care out of hours is a reflection of the changing demography of our patients. Older patients have more complex care needs and it is important that NHS services are designed to provide anticipatory care to try, as far as possible, to avoid the need for urgent out-of-hours care.”

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