GP patient lists are formally closed to new registrants at almost one in ten Scottish GP practices, according to new research from the BMA.
The doctors’ union warned that general practice in Scotland is in ‘a sustainability crisis,’ with almost a quarter of a million more patients than 10 years ago and almost 90 fewer GP practices.
The research revealed that while the number of GP practices in Scotland is falling, the average number of patients per whole time equivalent GP has increased from 1,499 to 1,687.
It highlighted that between 2013 and 2023, the number of GP practices in Scotland dropped from 994 to 905 and eight practices have indicated they plan to hand their GMS contracts back to the health board this year.
At the same time, practice list sizes have increased in most of Scotland, with the practice population of Lothian rising by 8.16% in just five years.
Dr Andrew Buist, who chairs the BMA’s Scottish GP committee, said that these trends are ‘extremely worrying’ and that the data on the dashboard indicates that ‘nowhere is safe or sustainable for general practice currently’.
He said: ‘The only area we are seeing a decrease in the average number of patients per WTE GP is Orkney – everywhere else is reporting increasing patient numbers with fewer GPs and fewer practices overall.
‘It is simply unsustainable, and we are seeing that now in the numbers of GP practices which have closed their lists to patients over the past few years because they would be unable to safely provide the level of care required if they continued to take on new patients.’
He said that further increasing pressures are leading to ‘a domino effect’ of practice closures, adding: ‘This is a cause of great worry for GPs, who want to continue giving their patients the best care possible but due to issues around retention, recruitment and funding are unable to meet the level of demand.
‘But not only this, it is very concerning for patients, particularly older and more vulnerable patients who will be left wondering where they go from here, faced with the prospect of a practice that is unfamiliar to them and GPs who do not know their history.’
In 2017 the Scottish government pledged an additional 800 GPs by 2027, but Dr Buist said that six years down the line only 113 new GPs have been recruited and the WTE has actually decreased by 3.4% since 2019.
‘While we may be training more GPs they are barely keeping pace with the premature losses the profession is suffering due to failure to retain – the bucket we are filling has a large hole in it and levels will continue to drop until that is repaired,’ he added.
Dr Buist is meeting with health secretary Michael Matheson today to ‘deliver the warning in person’.
Last month, data showed that almost one in ten Scottish GP practices has been taken over by health boards as staff shortages force partners into handing back their contracts.