'No immediate solution' to GP shortage behind Scottish out-of-hours shutdown

NHS officials have said there is 'no immediate solution' to Scotland's primary care staff shortages following the three-month closure of out-of-hours GP services in Fife.

Out-of-hours GP shortage (Photo: istock.com/sturti)
Out-of-hours GP shortage (Photo: istock.com/sturti)

NHS managers in the city took the decision to shut down overnight GP services at three locations between April and June this year after finding it impossible to fill shifts.

Patients who would normally use services in St Andrews, Glenrothes and Dunfermline are instead being asked to travel to Victoria hospital in Kirkcaldy for treatment between midnight and 8am.

The temporary shutdown of services in Fife came after official data published last month revealed that every NHS board in Scotland had been forced to 'take actions' due to being unable to fill GP out-of-hours shifts.

Michael Kellet, director of Fife Health and Social Care Partnership, said: ‘As with most areas in Scotland, there are growing difficulties ensuring clinical cover in GP out-of-hours services. This is due to national shortages of GPs and urgent care practitioners.’

GP shortage

Mr Kellet highlighted the enormous pressure facing GPs and other primary care staff in Scotland, saying that despite the 'considerable efforts of colleagues in primary care', the area's primary care emergency services (PCES) had become unsustainable in Fife.

'From the end of March it became clear that from early April the PCES would be unable to sustain the overnight service across three bases.'

He added: 'Due to the extent of the staffing shortages both locally and nationally, there is no immediate solution to the staffing challenges that the service faces. Every effort is being made to re-instate the service as soon as possible. The position will be reviewed again in three months time.'

He said the service had been redesigned to boost the role played by nurses, but nursing shifts had also proven difficult to fill - with GPs sometimes required to provide cover.

New contract

'In addition to recruiting and developing the nursing workforce, we have placed an advertisement for GPs to increase the amount of GP cover within the service,' said Mr Kellet. 'Despite the ongoing efforts to improve the service and attract staff the national shortages of these key practitioners have affected and continue to impact on Fife.’

GPC Scotland deputy chair Dr Andrew Buist said: ‘General practice in Scotland has faced significant difficulties in recruitment and retention, with around one in four practices reporting vacancies. It is unfortunately the case that these recruitment difficulties also affect out-of-hours services, particularly as many GPs have taken on higher workloads to maintain services during daytime hours.

‘It is only by solving the recruitment and retention challenges in general practice as a whole that we can expect to solve this issue in out-of-hours services.’

A report published last month by ISD Scotland warned that all NHS boards reported having to take 'additional action' to ensure that GP out-of-hours shifts were filled, with more than half saying they had to do so on a weekly basis.

Dr Buist said the new Scottish GP contract, which took effect from 1 April, would help to ‘address the unmanageable workloads that GPs face and help make general practice a more attractive career option’. The deal includes a new opt-in ‘enhanced’ service for practices that choose to provide out-of-hours services.

Read more
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