Scotland needs new target to increase GP workforce, says RCGP

RCGP Scotland has called on the Scottish government to introduce a new target to increase the number of whole-time equivalent (WTE) GPs, after research by the college found that 37% of GPs feel so overwhelmed by their daily tasks they are unable to cope at least once per week.

RCGP Scotland chair Dr Carey Lunan (Photo: Pete Hill)
RCGP Scotland chair Dr Carey Lunan (Photo: Pete Hill)

In a new report called From the Frontline, the college said the new workforce target should set out how many WTE GPs were needed by 2024/25 to meet growing demand and tackle sprialling GP workload.

The college highlighted that there had been a 4% fall in the number of WTE GPs in the country between 2013 and 2017, while in the same period the number of WTE consultant posts increased by almost 15%. It also pointed out that over a third (36%) of all GPs working in Scotland are aged 50 or over, which was a 'cause for concern'.

The RCGP said that investment was required to enable '25% of the undergraduate medical school curriculum to be delivered in primary care’, which would promote general practice to a ‘new generation of doctors’.

GP funding

The report forms part the college's new #RenewGP campaign, which sets out how Scottish general practice can be made ‘fit for the future’.

The campaign reiterates RCGP Scotland's call for general practice to receive 11% of Scottish NHS funding. The college said this would help to increase the GP workforce and ensure additional funding went to areas with the highest patient need, which would enable general practice to effectively tackle ‘the root causes of health inequalities’.

The campaign also backs calls set out in the college’s UK-wide vision for general practice, which was published last month, that 15-minute GP appointments should be introduced as standard. However, RCGP Scotland said that this could only be achieved by recruiting more GPs.

In addition, the report said more research was needed to understand why GPs leave the profession at different points in their career, highlighting figures that showed 26% of GPs in the country say they are unlikely to be working in general practice in five years time.

It suggested that in future GP appraisal should prioritise GP wellbeing and minimise the amount of paperwork required. The college also called for the Scottish government to set up a dedicated healthcare service for doctors in Scotland, like the GP Health Service in England, to help support GP wellbeing.

The report also said:

  • Health boards should proactively identify and support practices that are getting into difficulty using predictive toolkits and local intelligence data.
  • Clusters should have an agreed, equitable minimum level of resource that allows adequate supported time and appropriate administrative support for the cluster quality leads to fulfil the role.
  • There should be a minimum four-year, competency-based GP training scheme, embedded within practice.
  • Postgraduate GP training opportunities should enhance generalist, rather than specialist, skills.
  • All new digital services should be fully evaluated in terms of impact on patient safety, health inequalities and clinician workload before they are adopted more widely.
  • ‘Urgent investment’ in IT infrastructure is needed to improve interoperability, accessibility and the reliability of clinical systems.
  • Overall protected 'time to learn' for GPs should be increased to allow more opportunity for joint learning and service development with hospital colleagues.
  • A ‘national conversation’, led jointly by politicians, healthcare professionals and patients, should be undertaken to promote sustainable use of the NHS and safeguard its future.

Patients deserve better

RCGP Scotland chair Dr Carey Lunan said: ‘GPs tell us that workload pressures, rising patient demand and underinvestment in general practice are having a significant impact on them and their patients.

‘General practice is the backbone of a sustainable NHS. Our patients deserve better and it is time to renew general practice in Scotland. We are calling on Scottish government to commit to urgently bolster the GP workforce and increase the level of spending in general practice to 11% of the overall Scottish NHS budget.

‘Taking these steps will help ensure that general practice is able to provide high quality patient care that meets the current, and future, needs of patients in Scotland. With an increase to 11% of the NHS budget, additional GP funding would flow to the areas of highest patient need. This will help to tackle the root causes of health inequalities, improve GP recruitment into areas of deprivation which traditionally struggle to attract GPs, and reduce pressure on vital hospital services.’

GPC Scotland chair Dr Andrew Buist said: 'GPs are the first line of defence for our country against ill-health, and they need more support in tackling health inequalities. This report underlines why addressing GP workload, which has in recent years reached unsustainable levels, is so vital if we are to protect and grow GP numbers.

'That has been the BMA's priority in negotiating the new GP contract and now it is essential that the promises made to GPs on additional staff and services are delivered by health boards and the Scottish government.'

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