News Scotland
GP surgery staff have warned they are bearing the brunt of growing patient frustration at delays in trying to get an appointment with a doctor.
Scotland’s GPs claim a £290m funding gap means they can not afford to hire more staff to cope with increasing demand.
Workers at one medical practice in Aberdeen say they are increasingly “trying to do more with less”, leaving people waiting longer to be seen.
More than £1bn of the NHS Scotland’s budget is spent on GP surgeries every year and Scottish ministers have said they want to make it easier for people to see a doctor.
First Minister John Swinney has previously pledged to make it easier to get GP appointments.
A greater proportion of new NHS funding is now going to primary and community care.
But the British Medical Association (BMA) Scotland has raised a formal dispute with Scottish ministers, claiming GPs’ share of the health service budget has fallen every year against inflation since 2008.
The trade union also points to GP recruitment targets not being met, high vacancy rates and an increasing workload for doctors.
‘We can’t see everybody we want to’
The phones are never silent for long at the Elmbank GP surgery in Aberdeen where the current waiting time for a routine face-to-face appointment is more than four weeks.
Practice manager Heather Sharkey said the surgery’s list size has increased by 6% over the last year and they are “firefighting every single day just to do the best that we can”.
She said: “We can’t see everybody that we want to see.
“I would love to be able to hire more doctors. There are doctors in Scotland that can’t get jobs. But I haven’t got the funding available to be able to do that.”
She added: “It then translates into a frustration for the office staff who are dealing with that supply and demand issue, and have patients who are understandably frustrated, worried, and sick and just want to see their doctor.
“It can range from being incredibly understanding to ‘well if I die, it’s your fault’.”
Elmbank patient Margaret Junner said trying to get a GP appointment was a frustrating process.
She said: “You do think I’m a human being, I’ve got feelings, I’m sore and so on.
“And after a wee while you just give up.
“You’re maybe having to wait two or three weeks before you even get a phone call and if you’re in agony, or you’re unwell, you’re trying your best to make sure you’re looked after.”
Dr Chris Provan, a GP partner at Elmbank and chairman of the Royal College of General Practitioners in Scotland, added: “I’m very clear we don’t have enough GPs. We’re always struggling to fit patients in – we’re not able to provide the time and the service that we want to.
“I’ve seen the intensity of the GP job increasing and increasing so patients are suffering, and GPs are beginning to burn out.
“Many are leaving the profession or retiring early because of the intensity of their workload – which contributes to the fact that we don’t have enough GPs.”
Why are there not enough GPs in Scotland?
Nearly a decade ago the Scottish government unveiled plans to allow family doctors to spend more time with patients and cut their overall workload.
The central plank of this strategy was to increase the number of GPs in Scotland by at least 800 by 2027.
Earlier this year, spending watchdog Audit Scotland said this plan was failing to deliver and unlikely to hit the 2027 target.
A headcount of all GPs, including those undergoing the three-year training programme, shows a jump from a total of 4,904 in September, 2017 to 5,211in the same month last year.
However, Audit Scotland has said counting this way “does not sufficiently demonstrate the intended increase in GP capacity”.
Another measure for counting GPs – which reflects the fact that many of those included in the headcount work part-time – is called whole-time equivalent (WTE).
The estimated WTE for GPs in September 2017 was 3,520 and dropped to 3,453 in March this year.
Trade unions said this reflects the fact that many GPs have reduced their hours and not enough trainees are being hired to replace retiring GPs.
Extra investment for GPs
Last week, Health Secretary Neil Gray announced £15m to boost GP recruitment and capacity.
Gray pointed out that award came on top of more than £100m in the last two years to meet recommended pay increases and to support medical practices with sustainability.
He said: “We want to make it easier for people to see their GP and to achieve this we are working towards ensuring a greater proportion of new NHS funding goes to primary and community care.
“This new funding will help support capacity and ensure GPs and services in the community have the resources they need for their essential role in our health system.”
He added: “We remain in negotiations with the sector on the provision of further support in the future, but this initial instalment demonstrates this government’s commitment to supporting primary care and alleviating current pressures on the system.”
