Why walk-in GP clinics are just a sticking plaster for the NHS
The Scottish Government’s latest Budget includes a £36 million commitment to establish 16 new walk-in GP clinics. The first has already opened in Edinburgh, with ministers promising more than one million additional GP and nurse appointments.
The Scottish Government’s latest Budget includes a £36 million commitment to establish 16 new walk-in GP clinics. The first has already opened in Edinburgh, with ministers promising more than one million additional GP and nurse appointments.
On the surface, this sounds like decisive action on one of the issues voters consistently rank among their top concerns: access to primary care. Few would dispute that patients are finding it harder to secure timely GP appointments.
On the flip side, we’re already seeing cynicism, with some people branding the quick opening of the Edinburgh clinic “electioneering” and querying when we’ll see the rest open.
For me, there’s another critical question that needs to be asked. Does this proposal actually address the root causes of the problem?
Walk-in clinics may provide visible, short-term capacity. What they do not do is answer a more fundamental challenge: Scotland doesn’t currently have enough GPs to meet demand. Creating new points of access without materially expanding the workforce risks redistributing an already stretched resource rather than strengthening it.
Training a GP takes close to a decade. While international recruitment has a role to play, it cannot compensate quickly enough for the growing number of experienced GPs choosing early retirement under sustained pressure. The result is a shrinking workforce – as demand for care continues to rise.
The debate must therefore move beyond headline initiatives and towards structural reform. It is often overlooked that GP practices are independent contractors operating as small businesses within the NHS framework. Partners are not only clinicians; they are also responsible for staffing, premises, compliance and financial management. That dual role has become increasingly complex and risky.
The 2018 General Medical Services contract was intended to create a more sustainable model for primary care. It sought to reduce financial risk for practices, expand multidisciplinary teams and shift certain workloads away from GPs.
In practice, implementation has been uneven. A review last year found key commitments have not been fully delivered. The number of whole-time equivalent GPs has fallen, the number of practices has declined, and access pressures have intensified. In some areas, funding structures have inadvertently set health boards and practices in competition rather than partnership.
One of the most pressing issues remains premises risk. Many GP buildings are ageing, poorly maintained and no longer fit for modern multidisciplinary care. Rather than alleviating this burden, interpretations of funding arrangements have in some cases increased costs and uncertainty for practices. That is not a foundation for long-term stability.
If we are serious about improving patient access, then strengthening the practices we already have must be the starting point.
That means: creating a consistent, transparent funding framework that aligns health boards and practices as partners; addressing premises risk through meaningful capital investment and fair risk-sharing arrangements; developing targeted retention strategies to keep experienced GPs in practice for longer; ensuring multidisciplinary expansion reduces, rather than redistributes, GP workload.
When general practice is stable and well-supported, the entire health system functions more effectively. When it is fragile, pressure cascades into emergency departments and secondary care.
Additional funding is welcome. But money directed towards new access points without parallel structural reform risks creating public expectations that the system cannot meet. As we approach a Scottish Parliament election, all parties should be clear not only about how they will expand access, but how they will secure the viability of general practice for the next decade.
Without strong, sustainable GP practices, there is no functioning NHS.
Andy Drane is a Partner, Davidson Chalmers Stewart