OVERNIGHT medical centres are so short of GPs in Scotland this summer they have had to centralise services, use more nurses and enhance pay rates to cope.

A national shortage of family doctors has been compounded by the number taking leave during the holiday season leaving some health boards struggling more than usual for cover.

An informal survey of NHS boards found some areas are finding it more difficult than last year – when Lanarkshire and Tayside health boards both centralised out of hours clinics amid difficulties securing enough GP cover.

NHS Greater Glasgow and Clyde – where GP numbers tend to be more robust than other parts of Scotland – said they had had to close some of their out of hours GP clinics at short notice because there were not enough available doctors.

NHS Lothian has also had to restrict the number of centres accepting appointments outside surgery hours, at times, because of GP shortages. This means people with urgent medical problems may have had further to travel.

NHS Grampian said they had used higher rates of pay on occasion “to attract GPs to work at certain unsocial hours in some of the centres”.

Dr Sian Tucker, who chairs the National Operations Group for out of hours (OOH) services, said: "As usual at this time of year most OOHs services are finding it challenging to fill their GP rotas fully. This is compounded by the national shortage of GPs available both in and out of hours.

Boards have taken a number of different approaches to ensure they continue to provide safe and effective patient care, these have including increasing nursing cover, changing the use of bases (out of hours centres) for short periods of time and using cross cover from other bases and paying enhanced rates or using agency staff.”

In NHS Ayrshire and Arran a number of highly qualified nurses – known as Advanced Nurse Practitioners (ANPs) - have left the GP OOH service known as ADOC. It is understood the board drafted in nurses from the hospital division to cover the gaps.

Barbara Sweeney, senior officer for employment relations at the Royal College of Nursing, said: “RCN Scotland is aware that there is a gap in staffing in relation to ANPs trained to work in the out of hours service across the Ayrshire and Arran health board area, which has resulted in changes to shift patterns with ANPs who normally work in acute services being relocated to the out of hours service.”

She added: “Where senior nurses have been asked to cover out of hours clinics, it’s crucial that the health board provides adequate training for them on the ADOC IT software in addition to clear pathways in accessing medical advice and support from GPs.”

NHS Ayrshire and Arran said:

A spokeswoman for NHS GGC said: “During the holiday period in particular in can be difficult to fully staff our primary care emergency centres. Despite the assistance we get from GPs, including the support of many who come in at short notice, we have had to make short notice closures of centres when we do not have GP cover.”

Most recently the out of hours centre at Gartnavel General had to shut.

The Scottish Government commissioned Professor Sir Lewis Ritchie to conduct a review of out of hours services which was published last November.

His report described a system under “chronic stress” and proposed that those who needed urgent care during evenings and weekends were seen by mixed teams of nurses, pharmacists, therapists and social care staff based in "urgent care hubs.

Ms Tucker said: “We are working with the primary care division of the Scottish Government to implement the recommendations of the Ritchie Review.”