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GP practices ‘face collapse’ as promised new contract is ‘taking too long’ to materialise

Promised additional funding for general practice in Scotland is not coming fast enough say GPs who warn multiple practices face collapse before the new contract is finalised later this year.

Figures show a deteriorating situation with 52 practices – one in 20 – now being run by health boards under 2C contracts.

Pulse has learned that in the past five years, nine practices have closed their doors for good, dispersing more than 24,000 patients.

This came as a BMA survey found that as of May one in four practices had at least one GP vacancy with 73% of unfilled jobs being empty for six months or longer.

Some areas have been hit particularly hard, including Lothian where a lack of investment against the backdrop of a rising population has left GPs ‘vulnerable across the board’.

The area has a higher than average vacancy rate, has eight practices run by the health board, five of which were taken over in 2016/17, and more practices are ‘facing collapse’.

Lothian LMC chair Dr Catriona Morton said they were now in a very difficult position and had been promised more funding but it was not getting to front line services quickly enough.

She said: ‘We feel we are going to have more practices that will fail and become 2C or collapse completely. The board is giving us insufficient help now, the Government is giving us insufficient help now.

‘We really welcome the new contract but for some practices it won’t come fast enough.’

Dr Morton added that primary care in Lothian had been promised an additional £5 million by 2020 but ‘six-to eight months on we will haven’t seen a single drop of that in general practice’.

The Scottish Government has promised £500m for primary care by 2020 and a new contract is being negotiated in which pharmacists, nurses and other primary care professionals take on a greater role to reduce pressure on GPs

GPC chair Dr Alan McDevitt said the speed of instability was increasing and it was vital to get the new contract in place quickly.

Hr said: ‘The problem is there is a time lag and the shortage of GPs is happening much faster than our ability to implement the new contract.’

He added that some health boards were finding innovative ways to help practices including the development of the wider primary care team but that they did not have a magic wand on funding.

In addition, anecdotal evidence collected by the BMA suggested that it cost health boards at least twice as much to run practices themselves and they were becoming increasingly reluctant to take on that burden.

Dr McDevitt said: ‘They have to include management costs and the costs of temporary staff and it takes up enormous amounts of time for them and they are becoming increasingly keen not to take over practices.’

Dr Chris Black, joint secretary of Ayrshire and Arran LMC, where there is currently one 2C practice but two more who are due to hand contracts back later this summer, said they had called a meeting with the health board next week to try and resolve some of these issues.

‘The health board is engaging with us, but they are also operating under significant financial constraints,’ he said.

Scottish practices in difficulty

Closed since 2013 9
Managed by health board (as of May 2017) 52
Reporting at least one vacancy 26.5%

Sources: Pulse FOI, Scottish health boards and BMA