A MEDICAL leader has said a pledge to deliver support staff as physiotherapists and mental health workers into GP practices “has not been a priority” for some health boards.

Dr Andrew Buist, a Perthshire GP and chair of the the BMA’s Scottish GP Committee, spoke of his disappointment as the trade union and Scottish Government agreed to scrap the original April 2021 deadline that would have seen services such as childhood vaccinations and blood draws for diagnostic tests transferred to Health and Social Care Partnerships (HSCPs).

Patients were also supposed to benefit from having a range of other professionals directly employed by HSCPs but based within GP practices from April next year, such as pharmacists, physiotherapists, and community psychiatric nurses.

Workforce shortages and Covid have been blamed for delaying the plan, which was brokered as part of the 2018 Scottish GP contract and backed by a £250 million investment.

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It was seen as key to reducing GP workloads to enable them to spend more time with complex patients, while also enabling patients to see certain specialists quicker without needing to be referred onto hospital waiting lists.

Some GPs speaking during the annual Scottish GP conference yesterday said they had yet to receive an extra practice staff, with others warning that the continued uncertainty over the contract’s delivery was damaging recruitment and retention into the profession.

A new deadline of October 2021 has been set for the transfer of travel and childhood vaccinations from GPs to HSCPs, but transitional funding will be available until 2023 for practices where this is not delivered.

GPs will also be reimbursed until 2023 for continuing to provide other staff and services, such as phlebotomy, which are supposed to have been taken over by HSCPs.

Dr Buist said the revised timescale for “could be our last chance to get it right”.

“The sad fact of the matter is that it has not been seen as enough of a priority in some areas,” he added.

"I share the disappointment expressed [by GPs]. We, the negotiators, are working GPs, so we understand the impact this has.

"It can be done but there is unacceptable variation around the country and within cities."

Health Secretary Jeane Freeman, who delivered the keynote address at the conference, which was hosted online this year, said the pandemic has "thrown the timeline off track" and "stalled this more than any of us would wish".

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GPs from Glasgow's Local Medical Committee (LMC) put it to Ms Freeman that there had been "inadequate due diligence" at the outset of the contract to establish whether its goals were feasible and that adequate funding was being put in place to deliver them.

They asked what work is being done to ensure "this next phase won't be a failure", noting that HSCPs are "struggling to find enough skilled staff and have used up resource".

Ms Freeman said: "I don't think the contract has been a failure.

"I don't understand why local partnerships are feeding that message back because we have provided significant funding.

"If the funding is not reaching where it is needed I'm happy to look into that, but we should recognise what has been achieved."

An emergency motion proposing that the revised contract arrangements are escalated to the Scottish GP Committee for scrutiny by LMC members was voted through by conference attendees, amid concerns that it is unclear where the staff and funds are coming from to deliver its objectives by April 2023.

There are fears among some that money is being "thrown at" at a project which cannot be achieved.

Ms Freeman said £155m would be invested toward recruiting multidisciplinary team staff in 2021/22, on top of £205m spent so far.

NHS Greater Glasgow and Clyde said there has been "substantial progress" across its six partnership areas - which encompass 234 GP practices - including recruitment of 335 support staff for various roles, with plans to recruit a further 375 staff during 2021/22.

It said vaccinations for children and pregnant women have now been transferred from GPs to HSCPs, that all practices "have access to" pharmacy support, and "many practices" can access additional support from advance nurse practitioners, physiotherapists, and mental health.

However, Dr Sheena Fraser, a GP in Glasgow said her three-partner practice has had "no additional services" and were continuing to take patients' blood samples or manage minor ailments themselves that should now be the responsibility of the HSCP.

"These are continuing to distract us from focusing on patients with complex care needs," said Dr Fraser, adding that some other practices in their area had been allocated pharmacists or advanced nurse practitioners.

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Dr Mike Rennick told the conference his practice of over 10,000 patients in the Castlemilk area of Glasgow would need an estimated seven whole time equivalent pharmacists to deliver all aspects of the contract, but in Glasgow "the money has dried up".

He said: "This has been a huge investment and I'm concerned that it has failed to make much difference to our working lives thus far.

"The services run by the HSCP seem to carry a large a large price tag, go through many layers of management before anything comes to fruition, and it doesn't seem to take account of each individual practice's nuances."

Dr Rennick called for a national recruitment campaign for practice support staff, adding "how can we fill the posts if the people don't exist?".

Dr Simon Farrell, a GP in Ayr, said "there is a sense that staff are recruited from one another's areas" by HSCPs and that this is "destabilising existing workforces".

He added: "I'm not sure I believe that, without the pandemic, we would have been anywhere near implementing the GP contract in all areas of Scotland."