Covid Scotland: GPs are under huge pressure but have seen patients face-to-face throughout the pandemic despite what some politicians might have you believe – Dr Andrew Buist

There has been intense scrutiny of GP services over recent weeks – even more so than usual since a motion raised in the Scottish Parliament fuelled the misconception that GPs are refusing to see patients face-to-face.

I cannot be more clear when I stress that GPs have continued to see patients face-to-face throughout this pandemic, when it is both clinically appropriate and safe, for the patient and practice staff.

We are now steadily increasing the number of face-to-face consultations: in one day last week in my practice I saw 15 patients in person, while carrying out a number of telephone consultations in between.

Face-to-face appointments are available, but please understand it is not safe to go back to packed waiting rooms full of sick, potentially vulnerable people when the risk of Covid transmission is still high. We need to prioritise those who are most in need of in-person care and ensure they are not put at risk when they sit in a small, poorly ventilated waiting room.

Demand has increased by up to 100 per cent in some practices across the country. There simply aren’t enough GPs or hours in the day for every single patient who wants a face-to-face appointment to get one immediately. That is why many practices need to stick with the hybrid model of telephone triage and in-person appointments for those with greatest clinical priority for the time being.

We entered this pandemic with a capacity imbalance that has been further exposed: our patients want a certain level of care and we want that too, but right now, there just aren’t enough of us to provide this. And that’s hugely concerning.

The average full-time GP in central Scotland will have 1,500 to 1,600 patients: as the population has aged and consultation rates have risen, it’s no longer a manageable number.

GPs have continued to see patients face-to-face during the pandemic when necessary (Picture: Anthony Devlin/PA)

That’s why in 2018 we agreed the first entirely Scottish GP contract which sought to increase the number of GPs, increase investment in primary care, and expand the primary care multi-disciplinary teams, such as pharmacists, nurses, and mental-health practitioners. But unfortunately the pandemic struck before we had time to fully deliver on these commitments. Now we find ourselves in a situation where we are still desperately trying to work towards that, but with the added pressures of emerging from the pandemic.

All parts of the healthcare system are under massive pressure: there are long waiting lists for operations and hospital investigations, which means those people are needing help from their GPs and their teams to manage their condition longer than they would in normal times. We’re also seeing an earlier than normal increase in respiratory viruses this year which is putting further strain on the system. It’s a perfect storm.

General practice is the first point of contact for many people who need health care, so it’s the obvious place for people to take out their frustrations. But we are living this pandemic too, with our own worries, stresses and concerns. So I would urge anyone who is reading this, please be kind to your health and care professionals, and their staff – we are doing our very best in very difficult circumstances, with your best interests at the heart of what we do.

Dr Andrew Buist, GP partner and chair of BMA Scotland GP Committee

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