Cuts to the number of community links workers embedded in GP practices in Glasgow will have a "catastrophic" impact on patients in the most deprived areas, doctors have warned.
Health leaders in Glasgow are under pressure to reverse plans that would see the number of community links practitioner (CLP) posts slashed from nearly 70 full-time roles to 42 in 2024.
CLPs play a vital support role in GP practices by helping patients with non-medical problems which affect their health including housing, benefits, debt, fuel poverty, loneliness, abuse or access to food banks.
READ MORE: Call to reverse 'devastating' cuts to workers who help poorest Scots
Dr John Montgomery, whose GP practice in Govan took part in the original pilot for community links workers back in 2014 and has had a full-time CLP since then, said they were "absolutely invaluable".
He said: "Before we had links workers, people would come in for consultations with very real, very difficult social problems - whether it's related to benefits or housing or previous trauma - issues that you as a GP knew were impacting on their health, but that you're not trained to help people with.
"Now with a links worker, somebody comes in - they're having difficulty feeding their children, they're having problems heating their house - I can deal with the medical problems and get my links worker to phone them and help them navigate how to use food banks, how to liaise with housing associations, or the benefits system, which if you have issues with literacy can be an absolute nightmare for these patients."
Dr Montgomery's surgery, the David Elder Medical Practice, is one of 100 Deep End GP practices which serve the most socio-economically deprived populations in Scotland.
In a statement, the Deep End GP group described the cuts as "short-sighted" at a time when gaps in life expectancy are already widening between the richest and poorest Scots.
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They warned that it will result in "increased health inequality, increased demand on GPs and A&E, increased hospital admissions, greater health service costs and, most importantly, many preventable deaths".
Dr Montgomery added that losing full-time links workers from Deep End practices would also make it even harder to recruit and retain GPs at a time when many practices are already folding.
"I simply don’t know how I could do my job without them, and losing such a significant amount of their time and skill will be a catastrophe for my patient population,” he said.
The practice's full-time CLP, Emma MacDonald, said she is also anxious at the prospect of having to split her time across two or three practices.
She said: "I can just see us becoming spread so thin. Right now my caseload is sitting at over 60 people and I don't know how I could manage with double that.
"I've had the insight of helping out at a second practice [last winter] and the workload just became unmanageable at the end.
"I didn't feel that I was giving the best to the patients because I didn't have the time, and time is a big factor in helping people with these problems.
"GPs are so time-pushed so for [patients] to be able to come in and have an hour appointment with me is a real eye-opener - they don't realise they can have that time to talk to somebody.
"If that time is taken away, it's going to be really difficult."
READ MORE: Deep End GPs - what it's like working in Scotland's most deprived communities
The cuts come after the Scottish Government withdrew top up funding that had enabled the city to double its CLP numbers from around 30 in 2018.
Critics say the move goes against pledges to tackle poverty.
Rory Steel, GMB Scotland policy and external affairs officer, said: “The impact of deprivation on health and life expectancy in the poorest neighbourhoods in Scotland is not in question.
“The statistics are shocking and reveal lives being cut short, often by many years, simply because of where people live.
“The CLPs are doing crucial work on the front line of the battle to ease the toll of poverty on health.
"They are working in the most disadvantaged postcodes to help and protect patients at risk. We need more of them not less.
“To reduce their number would be needless and wrong at any time but given the first minister’s commitment to tackling poverty, it seems particularly shocking."
A spokesman for the Scottish Government said it was up to local integration authorities to decide how best to manage their resources, but that it expects services to "continue to provide the necessary support needed".
A spokeswoman for Glasgow City Health and Social Care Partnership said: “We are committed to the continuation of the community links worker programme, given the considerable benefits it brings patients.
“We expect these practices in Glasgow will continue to receive support from a Community Links Worker.
“However, we are only able to agree contracts based on our known income from Scottish Government at this time.
"Therefore it is anticipated some practices will see a reduction from a full time to a part-time worker come April next year.
"We continue our discussions with Scottish Government about the funding for future years”.
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