The issue of GP-patient relations and the workload of doctors has frequently been cause for concern. The findings, then, of the latest survey of the GP workforce across Scotland makes for interesting reading. It should act as a wake-up call to the Scottish Government on the pressures and priorities facing frontline general practice.
Once again, heavy workloads and their detrimental effect on consultation times with patients topped the concerns among GP respondents to the survey carried out by the BMA. Any profession or business has to heed the findings of research that point to the key challenge to face. General practice is no different, although the implementation of an effective response so often depends on how seriously government recognises the devil in the detail.
This survey is full of just that kind of detail, highlighting that more than half of GPs in Scotland want longer consultations with patients. It found, too, that heavy workloads were undermining the quality of service GPs could offer to those in their care.
Two months ago First Minister Nicola Sturgeon pledged that extra money would be invested in “GP practice and health centres”. This made some doctors uneasy, given that it suggested that not all of the £500 million promised by 2021would be devoted to the sharp end of general practice but instead would be absorbed by primary care “support services”.
If the survey results are anything to go by, full apportioning of that total sum is the most effective course of action. Again, the detail is crucial. As a pilot study at four surgeries in Glasgow , before the survey, showed that, when GPs spent longer with patients with complex needs, they ended up healthier in the long run.
GPs spending longer with patients was more cost effective approach than many prescription drugs and saved the NHS money. While the allocation of adequate funding is one thing, the survey has also revealed the need for structural rethinking. Present practice and workloads are unsustainable in the face of a changing GP workforce.
That workforce is ageing and there is an ever-growing vacancy rate in general practice. A record 28 per cent of GP practices have at least one vacancy for a doctor.
Clearly the time has come to ease this pressure and, as the survey indicates, there are various ways such things might be addressed, like making better use of pharmacists in the community.
Reducing day-to-day workloads on GPs might also encourage more of them to do more out-of-hours care, thus easing the burden on Accident and Emergency provision.
In the past there have been no shortage of warnings to he Government of the pressures and challenges general practice faces. How many more warnings will it take from those best placed inside the profession before our political leaders sit up and take notice?
This is not an issue that can be addressed at a future date. Appropriate funding dispersal and structural reforms need to be implemented at present if the bedrock of an effective general practice strategy for the future is to be put in place and extended throughout the country.
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