NHS Forth Valley: Lack of GPs could be forcing people to go to A&E

The head of NHS Forth Valley has admitted they do not know how many people are attending emergency departments because they can’t get GP appointments.

NHS Forth Valley board member Michele McClung raised the issue when the board met on Tuesday for the first time since it was placed in special measures by the Scottish Government.

The government intervention highlighted problems in particular with waiting times at Forth Valley Royal Hospital’s emergency department. Dr McClung said it was important to find out how much this was due to over-busy GPs.

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She said: “Everyone in this room will have tried to call their GP and will not have got an appointment – we won’t all go to A&E but some people do.”

A new initiative hopes to attract more GPs to Forth Valley

Dr McClung said members had “a good understanding” of the data around ED attendance, which has come under close scrutiny over recent months, adding: “I would really like a bit more information around what’s happening in GP’s surgeries – to see what’s happening and see what the correlation is around our increased attendance in out of hours and ED. We do know that there is a correlation between it – but do we know what the strength of that is?”

Dr McClung, who is also chair of Falkirk’s Integration Joint Board (IJB), began by saying she understood that GPs are not employed by the NHS – and she made it clear that local GPs have a good relationship with the health board.

NHS Forth Valley chief executive, Cathie Cowan, said at the moment there is a lack of data, which is also a national problem. She told the board that they are already engaging with GPs and propose to use some non-recurring funding to capture data “that would give us much more intelligence”.

There was also a promise to look at how many people were going to A&E because they had not been able to register with a GP, although NHS Forth Valley’s medical director, Andrew Murray, said that number would be “very few”.

NHS Forth Valley chief executive Cathie Cowan said there was a lack of data on GPs and people attending A&E

The meeting also heard about a new initiative that has been designed to help address the chronic shortage of GP’s in the Forth Valley area, where recruitment has been very difficult.

Patricia Cassidy, chief officer of Falkirk’s Integration Joint Board – which oversees health and social care – told members about a proposal to fund five new GP posts that aim to attract doctors who are interested in developing their careers.

The GPs would work across Forth Valley and spend one day a week in the hospital, concentrating on a specialism of their choice, with another day for study and professional development. The rest of the time they would be available to work for GPs, who would pay for their time, reducing the cost for local health partnerships.

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“It’s one way we are exploring how we can have a more sustainable GP workforce but also it supports their training and development so these posts will be quite attractive,” said Ms Cassidy.

The idea for the new posts came from Dr David Herron, clinical lead for Falkirk’s health and social care partnership. At a recent IJB meeting, he spoke about the “disconnect between access and demand” in Forth Valley, saying there is “strong evidence that access to GPs saves people’s lives and reduces hospital admissions”.

“Our GPs are working extraordinarily hard,” he said. “We are seeing 25-30,000 appointments per week in Forth Valley. This is way above what the GP contract was expected to fund so we have a problem with demand and capacity.”

With ongoing problems recruiting enough staff in Forth Valley, he said it was important that “we have to become the most attractive place for everyone to come and work”.