HEALTH boards across Scotland are struggling to find enough GPs to look after patients during evenings and weekends as the number of family doctors slumps by almost 100.
Paramedics have had to stand in for GPs on some occasions because managers could not find enough doctors to see people with urgent medical problems.
The scale of the crisis has been revealed by official figures which also show the number of GP surgeries with vacancies for doctors has doubled since 2013. Half these vacancies remained unfilled for more than six months.
Read more: Retired GPs targeted after figures show drop in full-time workforce
Creating a pool of retired GPs to fill-in when health centres are short is part of a £2m plan formed by the Scottish Government to address the problem.
But, Dr Alan McDevitt, Chair of the British Medical Association’s Scottish GP Committee and a practising GP in Clydebank, dismissed the extra funding as "nowhere near sufficient to make an impact on the problems facing general practice".
He said: "GPs are choosing to leave the profession and those that remain are facing an increasingly unmanageable workload. Without significant funding invested specifically in general practice recruitment and retention, the situation will only get worse."
Official NHS statisticians have released a bundle of information about staffing levels across GP surgeries and health centres. This revealed the number of GPs working for NHS Scotland has effectively dropped by 90 since the survey was last carried out in 2013. There were the equivalent of 3735 full-time doctors in 2013, dropping to 3645 by 2015. This is largely due to more doctors working part-time.
The survey also found one in five surgeries had a vacancy on August 31 last year and just over half those with empty posts said they were "unable to recruit".
The Royal College of GPs Scotland has been campaigning for extra investment and action to stem a staffing crisis for sometime.
Read more: Herald View - GP shortages point to perfect storm for NHS
Dr Miles Mack, chair of the college, said: "It is frustrating and worrying that those warnings have not been heeded. We are concerned that the 100 extra GP training places promised in October 2015 (by the Scottish Goverment), to start this current year, have not come about and that we have yet to hear a timescale for their delivery. Twenty per cent of last year’s training places went unfilled. We need urgent measures to make sure those places are available and taken up."
Every health board in Scotland, except for Shetland, told the NHS statisticians they have had to take action because of issues filling GP shifts during evenings and weekends when patients are seen at dedicated out of hours centres.
Most boards are unable to fill up to a third of shifts until 48 hours beforehand. NHS Ayrshire and Arran say the are running "undermanned" weekly, NHS Dumfries and Galloway said they have had to use paramedics to cover shifts "that we could not get covered any other way", two NHS boards described offering financial incentives to help fill shifts weekly. Extending the hours of doctors because of staffing shortages, was common.
Advanced nurses, known as emergency nurse practitioners, can help see patients during evenings and weekends but they are also in short supply. Two health boards reported that they were so short of these nurses they had to use GPs to fill these slots.
Dr Sian Tucker, who chairs the National Operations Group for out-of-hours services, said three years ago most out of hours shifts would be filled months in advance. Now, she said, there are mornings every week when text messages are being issued searching for doctors to work that night.
Read more: Overworked GPs - we can't avoid making mistakes
The Scottish Government's £2m funding package has been allocated to projects to boost GP recruitment and retention across the country. New support for rural GPs and doctors working in deprives areas are among the projects being established with the money.
Shona Robison, Scottish Health Secretary, said: "While Scotland continues to have the highest number of GPs per patient in the UK, we still need to act now to redesign the way care is provided in the community to ensure these services are sustainable in the future.
“That means transforming primary care and GP services - increasing the role that other health professionals play in delivering care and making it much more of a team approach, allowing GPs to focus on those patients specifically in need of their expertise."
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