GPS have warned that surgeries are facing a “perfect storm” as patients who are seeking pandemic-delayed appointments, flu vaccinations and mental health issues combine to drive a surge in consultations.
One doctor said his practice in Glasgow’s south side had experienced an almost 70 per cent rise in patient numbers and that he had serious concerns the pattern would continue into winter.
GPs have also attributed the rise to Covid inquiries from the public.
Doctors say there is a “misconception” amongst the public and even from hospital consultants that they are not seeing patients face-to-face, but have warned that some may opt for private care because of delays in securing appointments.
Another called for greater investment from the Government in general practice to tackle chronic staff shortages.
Dr John Montgomery of the David Elder Medical Practice, one of the so-called Deep End practices that serve the 100 most deprived communities in Scotland, carried out his own research looking at patient numbers through lockdown and over the subsequent months.
His figures show that the surgery in Govan experienced a 69 per cent rise in patient consultations in August – both in person and on the phone – compared with the same month last year.
In March, the practice saw 19% fewer patient appointments compared to the same month in 2019 as “patients tried to protect the NHS”.
The practice repeated the exercise in July and found consultations had risen by 38%, while the figure for August soared by 69%.
“Demand is going up quite significantly and patients are starting to struggle now with being told they have to book appointments,” he said.
“I have serious concerns if this keep going.
“Patients, if they have problems, are no longer hesitant in coming forward.
“Mental health consultations have gone up significantly so that’s going to be another
factor. Paradoxically we are now the first point of contact so we are getting things sent through to us that would be better dealt with by other professionals.”
He believes the majority of patients are happy to speak to a doctor over the phone.
“In some ways, it has improved things,” he said “Patients are sending us through pictures of moles and rashes –that’s been extremely useful.”
Dr Chris Johnstone, a retired GP, who now works for a Health and Social Care Partnership (HSCP) which manages around 29 surgeries, said he was keen to clear up the misconception that doctors are not seeing patients.
He said: “This is not true and I have had to put several consultants straight.
“This was not helped by the English NHS sending out a reminder to GPs in England to see patients which was picked up by the national news.”
Dr Philip Wilson is a Professor of Primary Care and Rural Health at the University of Aberdeen and retired from general practice in February at the age of 65. He said he had grown frustrated with the shift to remote consultations ahead of the pandemic.
He said: “It feels like I got out at the right time.
“I always felt that face-to-face consultations should be the mainstay of general practice.
“The key issue is that general practice is in a terrible mess: medical students don’t want to be GPs and I’m not even sure I would want to be one now if I was 40 years younger.
“And it seems like the Scottish Government is keen to replace GPs with other clinicians like pharmacists and advanced nurse practitioners so many GPs seem to have ended up just seeing people for the problems that are too difficult for the other team members to deal with.
“One really big concern I have about all this is that people who want personal continuity of care from a doctor will end up seeking private GP care and that would be a real disaster for the NHS.”
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Iain Morrison, chair of the GP sub-commitee at Lothian Local Medical Committee (LMC) and a practising GP in Newbattle, said “disinvestment” in general practice was partly to blame for the current pressures.
“Demand for general practices across Lothian is at an all-time high. It’s a bit of a perfect storm.
"There is considerable mental health challenges, there are a lot of people now coming forward with problems they have been holding on to and there’s still the usual demand that we have been dealing with.
“There is also the flu campaign which is causing a lot of calls and there is the background Covid situation.
“At the end of the day it comes down to needing more staff. We would love to see some further investment in general practice to try to improve staffing levels.
“This is partly a consequence of disinvestment in general practice.
"We welcome the investment that was made in 2018 but it’s not enough to address the imbalances.
A spokesman for the Scottish Government said: “By the end of this Parliament we’ll be investing an additional £500 million per year in Primary Care, including £250m in direct support of general practice.”
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