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BMA warns Scottish NHS overhaul is ‘doomed’ unless GPs are involved

GP leaders in Scotland are warning that radical plans to integrate health and social care into one organisation in the country must engage GPs or be 'doomed to failure'.

Pulse has learned BMA Scotland's response to the Scottish Government's ongoing consultation on proposed changes to replace the unpopular community health partnerships (CHPs) will warn that GPs need to be ‘at the heart' of those changes or they will walk away.

The Scottish Government plans to replace CHPs with new health and social care partnerships (HSCPs), which will have a much wider remit to plan and deliver health and social care through shared budgets and targets.

BMA Scotland will say that it will be essential for GPs to take a central role on the new partnership boards and that they should represent their community – for example, by including LMC leaders.

It will also say that the Government must ensure the overhaul does not result in the shift of more work from secondary care into primary care, further increasing the workload of GPs.

A BMA Scotland spokesperson said: ‘We have always advised a review of CHPs. We are very concerned about the failure of these locally and a lot of GPs have walked away from them. If this gives us an opportunity for improvement, then we welcome it.

‘But we want ensure GPs are involved in the new boards and that clinicians are also at the very heart of implementing changes. We need to ensure it will not lead to any further shift of work to primary care. That shift is not resourced either in terms of staff, premises or funding.'

Dr Douglas Colville, Scottish GPC member, medical secretary for the Glasgow LMC and a GP in Glasgow, said: ‘The CHPs have been a failure in that they have disenfranchised GPs. We would argue that GPs are at the frontline of care, and if the most important people are being disenfranchised then it is doomed to failure. Some of the new proposals are good, but it will only work if they really do involve GPs.

‘It is poor communication that has led to the disengagement of GPs in community care. In the new HSCPs, they recognise that and are trying to marry primary and social care in a more meaningful way. But what is often forgotten is that GPs run small businesses, and if money for locums is not provided then GPs cannot help.'

The deadline for responding to the public consultation, launched in July, has been extended to 11 September.

In launching the consultation, Scotland cabinet secretary for health Nicola Sturgeon said: 'The Scottish Government and its partners are committed to putting in place a system of health and social care that is robust, effective and efficient, and which reliably and sustainably ensures the high quality of support and care that is the right of the people of Scotland. Scotland is a small country with a proud history of social co-operation.' 

The news comes as Pulse revealed earlier this week that the Scottish Government was holding talks with GPs about which aspects of the GMS contract should be locally determined.