Scottish GP out-of-hours review to consider impact of recruitment crisis

A major review into the way GPs provide out-of-hours care in Scotland was announced by Scottish health secretary Shona Robison on Friday.

GP out-of-hours triage: Scottish review (photo: Christopher Jones)
GP out-of-hours triage: Scottish review (photo: Christopher Jones)

The move was welcomed by RCGP Scotland, which said the report was an opportunity to recognise the 'essential' role GPs play in providing care, 'whatever the time of day’.

The review will consider the recruitment and retention issues affecting general practice to decide how to ensure there are sufficient staff to deliver a consistent service, particularly during peak holiday times.

It comes as out-of-hours services in Lothian recorded their busiest day ever for home visits on 2 January. GPs had to deal with a 'staggering' 1,000 patients a day over the festive period, according to RCGP Scotland chairman Dr Miles Mack.

GPs were allowed to opt out of 24-hour responsibility for patients more than a decade ago as part of the 2004 UK GP contract. The review will be led by Professor Sir Lewis Ritchie.

Recommendations based on the review’s findings are expected to be released later this summer.

Time for change

Announcing the review, Ms Robison said: ‘Our NHS is facing different challenges from a decade ago and we need to ensure all parts of the system work as effectively as possible to support an ageing population and more people with more complex, multiple conditions.

‘That is why the time is right to review these services to ensure they continue to deliver sustainable, high quality, safe and effective care.’

Dr Mack called on the review to recognise the pressures GPs face and allocate more resources to general practice. He said: 'GPs are the hub of the NHS. That role does not change depending upon the date of time of day.

‘This review should concentrate on answering two specific questions. Firstly, how can the funding, capacity and workforce of GPs be increased to allow proper care to patients?

‘Secondly, how can we improve the connections, the interfaces, between general practices and the rest of the NHS? Patients would be surprised to learn how much room for improvement there is in order for different parts of the NHS to effectively share information with each other.'

The out-of-hours review will consider:

  • Care expected at night and at the weekend
  • Current best practice
  • Ensuring a high quality and safe experience for patients and health professionals
  • Core requirements for service at night and at the weekend, including roles and skills needed
  • Where service delivery of out-of-hours makes sense on a ‘Once for Scotland’ basis, and where local variation is needed
  • Pilots to test new models

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