Watchdog predicts problems in boosting GP workforce

Author: Adrian O'Dowd

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Scotland’s public spending watchdog has warned that it will be a significant challenge for the government to increase the number of people working in GP surgeries over the next few years.

In a workforce report* published today, Audit Scotland says the Scottish government will find it hard to meet its target – set in 2017 – to recruit 800 (headcount) new GPs by 2027.

Expanding the GP-based workforce is a key to the government's aim of moving more care into the community, but Audit Scotland said an ageing clinical workforce and problems with recruitment and retention would make this particularly difficult.

The audit looked at planning around the GP-based primary care workforce of GPs and the wider clinical multi-disciplinary team of nurses, allied health professionals (AHPs) and pharmacists, as they are central to the implementation of the new GMS contract in Scotland.

In the report, Audit Scotland underlined certain relevant points including the fact that more than a third of GPs are aged 50 and over, more than half of practice nurses are aged 50 and over, and the Scottish government itself had reported that between 2015-16 and 2017-18, only an additional 39 GPs were recruited as a result of recruitment and retention funding.

The report authors said that based on the number of additional GPs recruited to date, and the scale of pressures on the workforce, it would be challenging for the government to recruit an additional 800 GPs by 2027.

Government commitments to train additional GPs, nurses and midwives were on track, they said, but warned that it was unclear how many would go on to join the primary care workforce on the ground.

There was also a lack of national data on current workforce numbers, costs, activity and demand.

Such a data gap made it hard for the government to plan the workforce effectively and it would make it difficult to assess whether the new GP contract was achieving its aims.

People were generally positive about their experiences of primary care and would be happy to receive care from professionals other than doctors in a GP practice, said the authors, if they understood more about their roles.

However, it was clear that more needed to be done to explain changes in primary care to the public and how they affected the rest of the health system.

Caroline Gardner, auditor general for Scotland, said: “Scotland's primary care workforce is under pressure and operating in an uncertain climate. That makes detailed planning for the future even more important.

“To date, the Scottish government has introduced major policy changes without a reliable basis for its plans. It now needs to get a much clearer picture of the workforce and set out detailed plans addressing how its initiatives will improve patient care and deal with future demand on services.”

Scotland’s health secretary Jeane Freeman said: “Today’s report highlights the vital role primary care plays in delivering our long-term vision of shifting the balance of care towards community and preventative care.

“As we work to address the challenges in this area we are seeking to build on our record number of GPs by at least 800 in the next 10 years. This is backed by our substantial annual increases in primary care and general practice funding.

“The new GP contract and investment in multi-disciplinary teams is increasing capacity in primary care and helping patients to be seen at the right time by the right person. It will also help reduce GP workload, making the career even more attractive to new doctors.

“We are also taking action to build a workforce that can meet increasing demand. By 2020-21 we will have increased medical school places by 22% over 2016 levels, equivalent to an extra 190 places.”


*NHS workforce planning – part 2: The clinical workforce in general practice. Audit Scotland, August 2019.

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