NHS winter crisis: Scots GPs switching to 'emergency only' care as crisis deepens

GPs are being forced to text patients and warn them they can only take emergency appointments as pressure grows, a doctors’ union has revealed.

The Royal College of General Practitioners (RCGP) Scotland has warned GPs are under “sustained pressure on multiple fronts” ahead of a “very challenging winter” for NHS Scotland.

The Scottish Government’s failure to retain and recruit GPs has led to doctors implementing “never before seen” emergency measures in surgeries, the college’s joint chair Dr Chris Williams has said.

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The admission comes less than a fortnight after the worst-ever figures for accident-and-emergency (A&E) waiting times were published. More than 9,600 patients waited over four hours in an emergency department in Scotland in the final week of October.

Scotland’s health secretary Humza Yousaf is under pressure over GP shortages and A&E waiting times. Picture: PA
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Dr Williams has called on the Government to give “purposeful and simultaneous attention” to the “profound issues of workload, workforce, and welfare within general practice”.

“With the ongoing effects of the pandemic, a possible resurgence of the flu and the cost-of-living crisis, GPs are bracing for a very challenging winter, with serious concerns for the impact on patient care,” he said.

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"Contrary to some reports, general practice has been open throughout the pandemic. While RCGP Scotland agrees that there should be an appropriate mix of appointment types and booking methods available to patients, the ability for practices to provide this is constrained by GP capacity.

"We simply do not have enough GPs and demand has reached sky-high levels. GPs and their teams are implementing emergency measures, which have never before been seen in order to sustain their practices.”

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The RCGP further warned some of its members are putting off chronic disease management, and prioritising emergency work, with some members reaching out to patients via text message, warning them their surgeries will only give out emergency appointments for the time being.

Dr Williams said: "When combined with disappointing funding withdrawals from the Scottish Government and repeated messaging that patients are frustrated, Scotland's GP workforce has been left depleted and demoralised. The issues of recruitment and retention are inherently intertwined and require purposeful and simultaneous attention from the Scottish Government if we are to change course.

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"Short-term fixes to the health system must be paired with long-term strategic planning from the Scottish Government to address the profound issues of workload, workforce and welfare within general practice."

Dr Andrew Buist, chair of the British Medical Association's (BMA) Scotland GP committee, said some GPs were “facing abuse from frustrated patients”. He called for recent Government funding cuts of up to £70 million to be reversed.

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The BMA has said there are an estimated 312 whole-time equivalent vacancies across GP practices in Scotland.

“We’ve been saying for some time that greater investment for the recruitment of more GPs, and a clear focus on keeping those we already have, is essential to tackling the current pressures being seen in practices across Scotland,” Dr Buist aid. “The results of our recent survey of practices reiterate our previous warnings around the increasing demands GPs and their teams face.

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“Demand is still significantly outstripping capacity, with more than a third of practices that responded to the survey reporting having at least one GP vacancy – up from just over a quarter this time last year. The situation has only continued to deteriorate with GPs being blamed, and in some cases facing abuse, by frustrated patients.

“Despite pledges from the Scottish Government to support GPs and recruit more doctors, general practice has been let down further by funding cuts which threaten to undermine practices, at a time when they should be supported in offering patients the best possible care in the lead up to winter.

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“We truly are at a tipping point for general practice in Scotland, and GPs urgently need more government support, including crystal clear public messaging to manage expectations of what GPs can deliver under current pressures and for recent funding cuts to be reversed.”

Scottish Conservative shadow health secretary Dr Sandesh Gulhane demanded the sacking of health secretary Humza Yousaf, saying: “Successive SNP health secretaries' woeful workforce planning has led to a GPs crisis. Even well before the pandemic, they had failed to recruit enough GPs to meet the demand from patients and that has now reached breaking point across Scotland.

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“Humza Yousaf’s failures mean he cannot even retain the current GPs we have, never mind recruit new ones.”

Scottish Labour health spokesperson Jackie Baillie said “The health secretary must listen to this stark warning and reconsider his reckless plans to raid primary care budgets. This recruitment crisis has been years in the making, but the SNP have ignored warning after warning.

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“Now GPs are at breaking point, patients can’t get the help they need and our entire NHS will pay the price.”

A Scottish Government spokesperson said: “We have already delivered a record number of GPs working in Scotland, with more per head than any other country in the UK. To support GPs, we have recruited over 3,220 healthcare professionals into multi-disciplinary teams working alongside GPs.

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“We are committed to investing £170m a year to help grow these teams and to further increasing the number of GPs in Scotland. The Scottish Government also offers a £20,000 bursary incentive to GPs to increase rural and other hard to fill vacancies, and said last year’s trainee recruitment was the most successful year of any of the last five, with 98 per cent of GP training posts filled.”

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