Fewer GPs working out-of-hours in Scotland, new research finds

The number of GPs working out-of-hours in Scotland has declined, with researchers warning the service is relying on a small number of people having to work long hours.

A workforce survey published by Public Health Scotland yesterday found that most NHS boards across the nation reported decreases in the number of GPs working out-of-hours services, compared to the last survey in 2019, that some of them had difficulties filling shifts and had to divert patients to A&E.

Eight boards also had to take additional action ‘at least weekly’ to ensure shifts are filled, either by extending shifts, having nurses cover GP shifts, reducing triage cover or use of standby/on-call/backup shifts.

The report said: ‘OOH services are reliant on a relatively small number of GPs carrying out a notable proportion of the hours worked.

‘Within OOH services, 9% of the GPs worked 1,000 hours or more over the year and their total annual hours accounted for nearly half (44%) of the total GP hours worked.

‘At a national level there is awareness of the issues with GP recruitment and the impact of pension tax changes.’

It also found that GPs over 45 worked a higher average number of hours per week in OOH services than younger GPs, with the highest average hours worked by GPs aged 60 to 64.

Large declines were reported across the boards, including a decrease of 27% in NHS Greater Glasgow and Clyde to a decrease of 63% in NHS Fife.

NHS Lothian, NHS Ayrshire and Arran and NHS Lanarkshire reported declines in headcount of 5%, 6% and 10% respectively.

NHS Tayside was the only board which did not report a decrease in the number of GPs working for the service.

The report added: ‘Alongside issues of GP recruitment, several boards mentioned that Covid-19 absences during this time period had affected their ability to fill shifts.

‘Many boards noted that considerable effort is required to fill shifts, including sometimes changing shift patterns, amending staff profiles or otherwise altering service provision.

‘Two boards also reported having taken other actions when shifts could not be filled as planned, with NHS Borders reporting having to divert patients to A&E.’

Dr Catriona Morton, deputy chair of RCGP Scotland, told The Herald that the figures were ‘very disappointing’ but came amid ‘very high levels of demand’ on day-to-day general practice.

She said: ‘GPs are not contractually obliged to work in the OOH service, and after facing these immense pressures during in-hours general practice, many report not feeling able to work in OOH too.

‘It is crucial that OOH general practice be a place where GPs and other doctors feel supported, not overwhelmed, and can work safely.’

It comes as an RCGP survey of members – open to all practice staff, in field from December last year to last month – found that 31.7% of the 181 general practice staff Scottish respondents said their practice was at risk of closing over the next few months.

According to the research, GPs have identified unmanageable workload, GP partners leaving the profession and a shortage of salaried GPs as the main reasons for potential practice closures.