Exclusive:Locum GPs say they are 'going unemployed' in Scotland despite frontline NHS crisis

A survey found one locum had even resorted to driving an Uber

Locum GPs are considering leaving the NHS or moving abroad because they are struggling to find work in Scotland, a “shocking” new survey has found, despite unprecedented pressure on practices and rising demand for appointments.

The Lothian Association of Sessional GPs (LASGP) even heard from one locum who had resorted to driving an Uber to help cover school fees.

The British Medical Association (BMA) called the situation “perverse” and said it was caused by “many years of underfunding”, leaving surgeries without the necessary money to employ more GPs.

The Scottish Tories said it was a “graphic illustration of what’s wrong with the NHS”.

The BMA said GPs have been starved of funding | PA

A total of 66 locums responded to an email survey by LASGP in December, with 53 per cent saying they had considered leaving Scotland as a result of the current work climate for GPs. More than two thirds - 71.2 per cent - said they had thought about leaving the NHS or retiring early.

Elsewhere, 68.2 per cent said they had tried to diversify into “non GP NHS work”, or intended to do so.

LASGP said there is “a demand from the public and our partner/salaried colleagues for our skills and there is a supply of GPs but no means to allow these GPs to be paid for their work”.

October and November “saw many locums seeking work, but unable to find work”, it said, adding: “January and February predicts more locums seeking work but unemployed.”

It estimated resources amounting to more than 11,000 potential patient appointments a week had gone unused in October and November, while more than 14,000 a week would go unused across January and February.

LASGP aims to connect locum GPs - who fill temporary positions to cover absences, maternity leave or shortages - with job vacancies across Scotland.

Asked if they had taken on private work in the last year due to the NHS GP job climate, one survey respondent replied: “Uber driver to help cover school fee increase.”

Another said they were “working back in Australia intermittently”, while one answered: “Not yet, but looking at the next three months the situation is dire and I will need to do additional work of ANY kind including non medical work if the situation does not improve. I am an enthusiastic GP with over 25 years experience.”

NHS Lothian said the survey covered all of Scotland, not just the Lothians. However, it is understood the locums surveyed are mainly from the Lothians and surrounding areas.

Dr Al Miles, deputy chair of the BMA Scottish general practitioners committee, said: "Locum and salaried GP unemployment is an issue which has emerged in the past two years in Scotland. It affects all parts of the country and is worsening.

“It is due to many years of underfunding of core general practice, which accelerated under the 2018 GMS [General Medical Services] contract which effectively starved GP surgeries of funding. The proportion of the NHS budget spent in general practice has fallen from 11 per cent fifteen years ago to approximately 6 per cent now.

“The end result of this is that while there is ever increasing demand for GP appointments, there is no additional money available to practices to employ more GPs and GPs have been burning themselves out trying to meet the demand.

“We are now in the perverse situation where Scotland is paying to train new GPs but as there are no jobs available, increasingly many GPs find alternative work or emigrate to work in other countries.

“The solution to this problem is increased investment in the core GP contract, which will allow GP practices to employ more GPs, to meet the needs of our population.”

Dr Chris Williams, Scotland vice chair of the Royal College of General Practitioners, said GPs “are under unprecedented levels of pressure”, adding: “Many GP practices are crying out for more GPs to ensure they can deliver safe and timely patient care.

"It is therefore highly frustrating to hear many sessional GPs in Lothian are seeking work but cannot secure it locally. It sends completely the wrong message to our GP trainees who are put through intensive training programmes to qualify as a GP.

"GP practices are in dire financial headwinds due to historic underinvestment, inflationary pressures, and the impending increase in employer's national insurance contributions.”

Conservative MSP Jeremy Balfour, who represents Lothian, said: “This shocking survey is a graphic illustration of what’s wrong with the NHS under the SNP.

“People in Lothian, and across Scotland, are finding it harder and harder to get appointments because of a chronic shortage of full-time, permanent GPs.

“Here we have a bank of willing and able locums who could pick up some of the slack and yet they are not being utilised, presumably because there’s not enough money in that particular pot.

“It’s absurd that a qualified GP is having to drive a taxi because they are not getting enough shifts. It speaks to an inflexible health service and resources not being targeted in the right areas by the SNP.

“Saving money on primary care is the ultimate false economy, as it leads desperate patients to go to overstretched A&E wards instead and can lead to greater health problems down the line.

“It could also put off medical students from going into general practice, which could in turn exacerbate the GP shortfall in future.”

A Scottish Government spokesperson said: “We are investing an additional £73.2 million in General Practice this financial year to provide a pay uplift for GPs and to support GP practices to retain and recruit key staff.

“We have a higher number of GPs per head of population than the rest of the UK, and our budget for next year will support GPs to increase capacity through record funding for the health service.”

Jenny Long, director of primary care at NHS Lothian said: “NHS Lothian continues to work closely with colleagues in the Lothian local medical committee, which represents all GP contractors within Lothian, as well as working with Scottish Government colleagues to support the national programme of primary care reform. This is to ensure primary care services are sustainable and accessible, and patients can access the right care from the right person at the right time.”

She said the GP funding model is “nationally agreed”, adding: “Locum positions provide flexibility for individuals, but the stability of a permanent workforce provides an improved service for practices and patients.

“There has been recent focus in other roles within the general practice multi-disciplinary team with advanced nurse practitioners, pharmacists, physiotherapists, mental health nurses and others joining the wider primary care team to support patients. This has been a national policy to support GPs to focus on the most complex patients in their role as expert medical generalist.”