Out-of-hours GP services at risk, medics warn

OUT-of-Hours GP services in Scotland are in danger of “lurching from one crisis to another” due to problems getting enough doctors to work evenings and weekends, medics have warned.

Out-of-hours GP services are at risk. Picture: Getty

A British Medical Association (BMA) conference in Clydebank next week will hear concerns that some out-of-hours services have been unable to recruit adequate numbers of doctors to fill their rotas.

Doctors say part of the problem is that GPs’ heavy daytime workload makes many unwilling to take on extra hours at night and during weekends.

Speaking ahead of the conference, Dr John Ip said major problems filling rotas seen last summer and at the end of last year could emerge again unless action is taken.

It comes after Scotland on Sunday last year revealed concerns over the provision of out-of-hours services, with boards having to take emergency measures such as bringing in doctors from outside Scotland or using nurses and paramedics to fill shifts. Next week’s BMA Scottish GPs conference will hear doctors debating a motion outlining concerns that some out-of-hours services had been unable to recruit adequate numbers of doctors to fill shifts and to maintain services.

The motion says more GPs would take part in out-of-hours care if their daytime workload was less intense and the service was better resourced. It calls on the government to ensure health boards invest in primary care out-of-hours services “to support a high-quality service”.

Dr Ip said recruitment problems for out-of-hours services tended to be greatest around holiday periods. “GPs are working ten or 12 hours a day in practice. At the end of the day, you are exhausted and you don’t have the physical energy to do an out-of-hours shift.”

Dr Ip said action was needed to address the workload of GPs during the day, such as recruiting more doctors, as well as tackling the amount of work done out-of-hours.

“Out-of-hours services are also getting very busy. If you’re on a six-hour shift, often you won’t get a break at all. You are going from one housecall to another. There is a relentless pressure.”

Dr Ip, a GP in Paisley, said increased pay may be one element in recruiting more GPs to cover unsociable hours. “If the pay is more attractive then people might be willing to reduce aspects of their daytime commitment to work out of hours.”

And he said recruiting more GPs would also help, with the BMA having called for significant investment in general practice for some time. He said action was needed to prevent out-of-hours services reaching a crisis every time problems occurred filling rotas. In the worst cases, it could mean services having to be closed and patients having to travel further for care.

Margaret Watt, chair of the Scotland Patients Association, said: “We should be worried about this. We need to bring more in to solve the problem.”

A Scottish Government spokesman said: “The number of GPs has increased by 5.7 per cent since 2006, and there are more GPs per head of population in Scotland, when compared with NHS England.”