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Independents' Day

GP workforce shortages led to out-of-hours closures over 100 times in one city

Exclusive Out-of-hours centres in Glasgow were closed on more than 100 occasions over a 12-month period due to a lack of GPs, data collected by Pulse shows.

In response to a freedom of information request, NHS Greater Glasgow and Clyde said in the year leading up to May 2018, there were 106 closures among their eight primary care emergency centres because there was no GP cover.

Patients would have been able to access other out-of-hours centres or a home visiting service, the health board said.

Local newspapers reported that on one Sunday night in June – after the time period covered by the FOI response – a shortage of GPs left only one out-of-hours centre open in the region and patients being asked to go to A&E.

A spokesperson for NHS GGC – the biggest health board in Scotland covering 1.2 million patients and employing a quarter of the NHS Scotland workforce – said the challenge of funding GPs willing to cover out of hours was not a unique one.

In 2017, a group of GPs raised concerns about the future of an out-of-hours service run by NHS GGC at the Vale of Leven Hospital after repeated closures meant patients having to travel 25 miles to access the service.

In response to the concerns, NHS GGC said they were facing significant challenges staffing out of hours across all eight of their services.

The health board said it was continuing to review how best to deliver a sustainable GP out-of-hours service in the longer term.

A spokesperson added: ‘The review is ongoing and is part of a wider discussion on how to enhance the overall out-of-hours health and social care services for all our patients.

‘Patients are reminded not to attend a GP out-of-hours service without first calling NHS 24 who will direct them to most appropriate healthcare service for their needs.’

Out-of-hours services across Scotland are struggling to staff rotas partly due to a knock-on effect from GP shortages in the daytime.

NHS Fife has cut overnight primary care services at three hospitals for a trial period of three months because they were unable to cover shifts.

BMA figures collected in 2017 suggest more than one in four practices have a vacancy.

The Scottish Government has made a commitment to boost the number of GPs by 800 over the next decade and has proposed a recruitment campaign to attract doctors from the rest of the UK.

BMA Scotland GP Committee chair Dr Alan McDevitt said the figure was not surprising given the challenge of GP recruitment and retention faced in Scotland.

‘It is important the health board plans effectively to ensure that patient care is safe and effective for the period when out of hours services are not operating.’

He added: ‘Longer term, it is vital that work continues to ensure that working as a GP is an attractive career choice, and that we focus on retaining the GPs we already have.

‘While not specifically concerned with out-of-hours care, the new GP contract demonstrates the significant efforts being made in this area, which must be built on, along with action to make sure out of hours primary care is sustainable across Scotland.’

Last year, a Pulse investigation found that out-of-hours services across the UK are increasingly stretched with one in 10 providers had no overnight GP cover, with increasing numbers of GPs in Wales refusing to do out-of-hours shifts because of unsafe working.

Another Pulse investigation, carried out earlier this year, revealed a 26% increase in the number of serious incidences reported by GP out-of-hours services to UK commissioners last year, with GP leaders warning that they are no longer a 'safe pace of work' and that there is an 'urgent crisis' in the service.


Readers' comments (15)

  • National Hopeless Service

    Matt, We need an app with AI fast and some social prescribed gardening asap.

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  • if out of hours services were happy to pick up indemnity costs we could do more. how do we have that conversation? if out of hours service providers could have this reimbursed from NHSe or commisioners? then great. will be interesting to see what happens to services in April.

    my hope is that once the NHS picks up indemnity costs that the services will stabilise and this will improve shift fill rate.

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  • Some keen journalist (hint, hint Pulse) should apply for FOI requests asking for the same info about closures/rota-gaps for all OOH providers. It’s clearly not just Glasgow.

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  • No indemnity cover........... no OOH work from me........

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  • It might be good to look at this from a lateral thinking point of you. Let me go off tangent for a moment and I will come back. Babylon is funded by venture capital. The value of the company, like other new uber-style Internet-based services (Amazon, Facebook, TripAdvisor, Uber..) is based on the rate of growth of the company. None of these companies made any profit for years and many still do not. Babylon pays its Doctors substantially more than equivalent NHS organisations do. They also cover indemnity. So long as Babylon is growing in taking on new patients either through its private service, which is incredibly cheap, or through GP at hand it’s value increases. The expectation is that at some time, maybe after 10 years or more it will make a profit. So existing investors can exit the company with profits at any time with a profit despite the company never having made a profit. The larger the company the more Political power it develops. It eventually becomes ‘too big to fail’ and will be bailed out, if required.

    Do I need to bring this back to present OOH services?

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  • AlanAlmond

    The answer is to completely privatise the NHS, run the service at an incredible loss, with the ‘right people’ making money anyway off the backs of shareholders and pension schemes and then watch as the whole system goes spectacularly out of business and is bailed out at vast expense by our tax paying children. It’s ‘the only way’ and the current governments long term objective.

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  • The indemnity fees, tax and the manslaughter charges has put me off. You could be the only GP there under staffed and if someone dies, it is off to jail with manslaughter charges.

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  • I work in Glasgow OOH services ( not as my primary GP job) and the staffing levels are frankly dangerous at many times, esp on weekends. Despite repeatedly emailing management with multiple issues, nothing ever changes and when we have complaints we have no back up or support and are hung out to dry. Patients are repeatedly allowed just to turn up and not have to call NHS 24 then we get multiple complaints when they expect to be seen immediately , or from those that have bothered to call NHS 24. Ambulance calls are getting stupid, and blue light requests from us can take over 90 minutes to arrive- we are seen as a place of safety even though we have no equipment and very little drugs. And they pay is frankly disgusting-I believe Glasgow is the lowest paid OOH in Scotland. Due to all of the above I have stopped applying for shifts and I know many of my colleagues have done the same!

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  • Those lazy, overpaid GPs must be on the golf course. Good riddance. I know at least one paper that will be happy to have achieved the exodus of that blood sucking group.

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  • "The indemnity fees, tax and the manslaughter charges has put me off. You could be the only GP there under staffed and if someone dies, it is off to jail with manslaughter charges."

    Can we please make this headline news on national television, so that the country understands why the GMC and Government are failing to take responsibility for a failing system.

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