'We need urgent support' Scottish GPs have been pushed close to breaking point - Dr Iain Morrison

From the outside looking in, I imagine it’s easy to feel frustrated – but as a GP I am not exaggerating when I say General Practice in Scotland is experiencing its most challenging time in living memory.

GPs have been stretched throughout the pandemic

Before the pandemic we were in the midst of a recruitment and retention crisis, had a property portfolio in desperate need of upgrading and had embarked on an ambitious contract to add significant numbers of additional staff to help. The needs of our patients are constantly on our minds, and how best we can serve them, but we are struggling.

The immediate response to the pandemic was remarkable. Many colleagues postponed retirement plans and hundreds volunteered to come out of retirement to assist the cause. GPs across the country changed appointment systems overnight to protect their communities and staff from the spread of Covid-19. A move to remote consultation allowed for identification of need and ensured people still had access to healthcare. General practice spearheaded the shielding campaign, ensuring patients were advised and protected accordingly with plans created and information shared across networks. We also staffed the Covid triage lines and assessment centres to help deliver care and protect our healthcare systems.

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The altruism demonstrated felt entirely natural at the time. We remain in the midst of a pandemic we hope never to see again in our careers.

Unfortunately, as the pandemic has progressed many of the colleagues who returned or postponed retirement have left the workforce. The limitations in many buildings are being laid bare and we are desperately short-staffed across general practice and primary care. We continue to require infection control measures and physical distancing in our buildings. This means remote consultation prior to attendance must remain to ensure our waiting rooms do not have too many patients in at any one time. Appointment durations are longer as a result too, and we are therefore faced with significantly lower capacity unless we work longer and faster.

The effort has taken its toll on those who remain. The recent months with demand higher than pre-pandemic levels has pushed exhausted staff close to breaking point. We need urgent support, but we also need understanding from our patients. We want to see you face to face; in some circumstances it is the only way we can appropriately assess you – but we can only work within the limitations we have available to us right now.

The recovery from the pandemic offers the opportunity to build a healthcare system we all want to see. Allowing GPs to have more time with those with identified need massively improves patient and doctor satisfaction, health outcomes and reduces secondary care usage.

The former health secretary referred to general practice as “the bedrock of the NHS.” We urgently need a larger workforce. We need the public to respect the pressure we are under, be kind to our staff and to seek alternative support where it is deemed best. Finally, and possibly the biggest ask, we need politicians to be honest with the public about what can be offered with the resources available. I wish the new Health Secretary all the best in what will be a vital, and very demanding role.

Dr Iain Morrison is member of the BMA’s Scottish GP Committee and chair of Lothian LMC

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