Two newly qualified GPs are needed for every experienced doctor that retires because of young recruits opting for ‘portfolio careers’, a report on staff shortages has warned.
With newly qualified GPs preferring to work on a ‘less than full time basis’ signing up for five to six sessions a week, more are needed to sustain services when older GPs who were doing eight or nine sessions retire or leave, the report on workforce issues in North Ayrshire said.
In addition, GPs are retiring far faster than new doctors coming in, training places remain unfilled and doctors are moving out of the area, all contributing to an ‘increasingly fragile’ general practice.
The report also points out that with demand for services at an all time high at the same time as a shrinking share of NHS funding, traditional GP jobs are becoming less attractive to newly qualified doctors.
It paints a bleak picture for the 20 practices in North Ayrshire – with one currently run by the health board, another likely to be handing back its contract in August and three others suffering significant recruitment problems.
It points out as the remaining GPs experience job stress related to recruitment and retention issues within their current practice, ‘the threshold for quitting and moving is lower than in previous times’.
The report also says the need to use locums to cover shortages is further jeopardising the ‘financial viability’ of practices being run by the health board with sessional costs increasing to ‘unaffordable levels’.
Strategies in place to secure general practice outlined by the report include a tool to assess the extent to which a practice may be in difficulty and close working with practices who are struggling, including exploring options for non-medical input.
One scheme is looking at developing multi-disciplinary team across children and families, mental health; and community care to help take the pressure off GPs.
Dr Chris Black, joint secretary of Ayrshire and Arran LMC, said the changes in the way GPs work is ‘reflective of the intensity of the job’ with doctors no longer willing or able to do eight or nine sessions.
He added that the problems seen in Ayrshire were not particularly unique with the vacancy rate similar to that seen across Scotland.
‘The impact of increased workload on general practice has been difficult even if you’re well staffed. If you have recruitment difficulties on top of that, it has a knock on effect and the status quo can’t continue.’
He said that the new contract due later this year would hopefully address some of the issues around workload.
‘The LMC continue to work hand in hand with the primary care team at the health board to find solutions for practices who are having difficulties but each case is different.
‘The problem is you can’t replace the GP with someone else,’ he added.