GPs in some parts of Scotland have been asked to only see urgent and emergency patients to help ease ‘unprecedented levels’ of pressure on the NHS.
On Tuesday (10 January) health secretary Humza Yousaf said that ‘this is the single most challenging winter that the NHS in Scotland has ever faced’, and announced that guidance had been issued to all health boards, outlining that they can take necessary steps to protect their patients, staff and services.
NHS Ayrshire & Arran asked GP practices to move to only seeing urgent and emergency care patients, due to the ‘overwhelming demand’ across general practice and the need to prioritise same day emergency care.
Claire Burden, chief executive of NHS Ayrshire & Arran, said this will ensure that GP practices are able to prioritise urgent care, palliative care, screening programmes and out of hours services, as well as being able to provide care for those with more complex needs.
She said: ‘Services across the whole health and care system remain under extreme pressure.
‘This is due to a combination of staff absence across the system, high bed occupancy levels in our acute and community hospitals, high levels of flu and covid in our community, some delayed transfers of care and high volumes of frail patients whose recovery includes complex care.
‘To address these issues, we have implemented a whole system response, where we are working with our partners to ease some of those pressures and improve services for people living in Ayrshire and Arran.
‘We are committed to providing safe and effective health and social care for our population in as timely a way as possible.’
Dr John Freestone, associate medical director for primary and urgent care services at NHS Ayrshire & Arran, told Pulse: ‘This is a whole-system response to the situation the hospitals are finding themselves in. We are inundated with patient demand at the minute and we are trying to make sure we support the system as much as possible, to decompress.
‘The reason we are stepping this back is that we are trying to prioritise the most needing patients in our community – the palliative care patients, the frail elderly, the most vulnerable patients and paediatric cases – so that they can find the care they need in the right place.
‘The pressure wards are under to get people out of the hospital is being felt through all the departments.
‘GP practices are overwhelmed with demand and they are doing everything they can but there’s only so much they can do, so this is a way of saying to them “please prioritise those most needing in our community, because you can’t do everything right now.”’
Some GP practices in Glasgow have also suspended routine services to focus on acute care, while some branch surgeries have closed with staff redeployed to support other health centres.
In Lanarkshire, a number of GP practices have been open additional days including Saturdays throughout January to help ease pressures.
Dr John Ip, medical director at Glasgow LMC, told Pulse that Scottish GP practices are seeing ‘unprecedented levels of demand’.
He said: ‘GPs are reporting that they are dealing with very high numbers of patients, often exceeding 40 to 50 patient contacts on a daily basis.
‘In many practices, daily demand is significantly exceeding capacity. Practice can use the flexibilities within the NHSGGC GP Escalation Framework to configure their services, with a focus on urgent care, prioritising those cases above less urgent requests for consultations.
‘This means that some patients will need to wait longer for their appointments. We ask that patients and their carers use GP services appropriately and to be mindful of the pressures that GPs and their staff are under at this time.’
In a message to staff, a spokesperson for NHS Glasgow and Clyde said: ‘We are aware of the intense pressures and challenges staff are currently facing in all our settings, including clinical and non-clinical, and we are continuing to work to explore ways to help alleviate pressure on all our teams and services.
‘The mental health and wellbeing of our staff is of paramount importance and we have a range of support services that are available to all NHSGGC and social care staff.’
In England, GPs in Devon have an agreement with their ICB to be able to declare ‘black alerts’ when they are overwhelmed with demand, triggering a situation where they only supply urgent care.
LMCs across England are working on rolling out the GPAS alert system, although its believed Devon is the only ICB that has acknowledged it.