One of the largest health service areas accounts for more than half of the GP surgeries in Scotland that are currently operating a restricted patient list.
At present 99 GP practices across the country impose some form of restriction, according to figures obtained under a Freedom of Information request. Of these 51 are in the Lothians with the next highest region being Fife, which imposes limits in 20 medical practices.
The restrictions which amount to “informal” closed lists can mean among other things that GPs are not accepting new patients or are only accepting a certain number of people per week who have moved into the area.
It is understood that there are no formal “closed” GP lists in the Lothians at present as this requires an application process and NHS board consent.
The latest figures have reignited debate over the role housing planners should play in factoring GP services into new build proposals.
The Royal College of General Practitioners (Scotland) is calling for planning applications to take account of the effect on the local provision of GPs in the same way they are required to consider local education requirements.
Dr Carey Lunan, pictured below, chair of RCGP Scotland said that across the country practices “simply cannot take on more patients”.
She said: “There is a recognised need for more homes in Scotland, especially more affordable housing, but the provision of housing must take account of the ability of general practices and other healthcare providers to offer safe and appropriate health services to these new developments. Right across the country, record numbers of practices are already operating with closed or restricted registration lists.”
Estimates suggest 618,978 people will live in Edinburgh alone by 2037, compared with 498,810 in 2015, a rise of more than 120,000 in just over 20 years.
Lunan added: “In 2016, we called for measures to be put in place to formalise the consideration of the impact of new homes on local family healthcare provision. If this does not happen, it may result in large numbers of new patients moving into an area and placing additional strain on an already-stretched GP service.”
The ongoing GP recruitment crisis has led the RCGP (Scotland) to predict a shortage of 856 GPs by 2021.
In January, the BMA’s Scottish GP Committee (SGPC) approved the proposed new GP contract for Scotland, following strong backing in a poll of the profession.
Chair of BMA Scotland’s GP committee Dr Alan McDevitt said: “When patient numbers are increasing rapidly and practices are unable to recruit, GPs can be left in a position where they are unable to routinely accept new patients.
“It is a particular challenge in areas where the population is growing rapidly, which is why it is essential that more consideration is given to the impact on health services when making planning decisions”.
Scottish Labour MSP Daniel Johnson said: “The fact that one in ten practices in Scotland have their list restricted to new patients shows that pressure is now at a tipping point. In Edinburgh, the Lothians and Fife, the data shows that the problem is much more severe.”
A Scottish Government spokesperson said: “The new proposed GP contract, backed by investment of £110 million in 2018-19 and jointly developed with the BMA, will ensure GPs can spend more time with patients and less time on bureaucracy, helping to cut doctors’ workload and make general practice an even more attractive career.
“Our ambition is to increase the number of GPs by at least 800 over ten years.
“When identifying locations for new housing, planning authorities should take account of infrastructure requirements, such as GP practices.”
Liberton Medical Group 1/6/16
Bruntsfield MP 3/4/17
Grange MG2 3/10/6
Southern Medical Group 1/4/16
Inchpark Surgery 19/10/16
Ferniehill MP 1/3/16
Gracemount MP 21/1/16
Conan Doyle 17/11/17
Southside Surgery 18/7/16
Marchmont MP1 18/10/17
St Leonards MP 18/9/17
Restalrig Park MC6 25/9/17
Brunton Place Surgery9 15/3/16
Baronscourt Surgery 9 9/11/15
Links Medical Practice 12 11/10/16
Summerside MP5 16/3/15
Victoria Practice14 1/8/16
Dr Gray & Partners – Bellevue8 30/10/17
Mill Lane16 8/1/18
St Triduana’s MP 12/12/17
Leith Mount MP8 8/1/18
Hopetoun Practice 20/7/17
Leith Surgery16 19/12/17
The Long House Surgery5 27/7/15
West End MP11 30/10/17
Eyre Medical Practice12 25/8/17
Stockbridge - Blue 1/4/16
Stockbridge - Green 16/5/16
Bangholm M8 24/8/16
Cramond MP14 7/11/16
Ladywell West14 10/11/16
Ladywell East14 10/11/16
East Craigs MP 2/10/17
Crewe Medical Centre4 2/10/17
Whinpark MC10 1/3/17
Colinton Surgery14 10/1/14
Riccarton General Practice14 25/9/14
Slateford MC7 4/5/15
Springwell MC10 6/3/17
Braids MC13 20/11/17
Sighthill Green Practice 13/7/17
Sighthill – Dr Rhein 8/1/18
Wester Hailes 18/7/17
Gilmore MP7 6/11/17
Sighthill – Dr Sharpe & Partners4 8/12/17
Dalkeith MP 1 /4/4
Quarryfoot MP 14/9/2015
Strathesk MP12 3/1/2018
Dalhousie MP 21/4/2016
Newbyres MG 6/2/2017
Pathhead MP 29/3/2017
Armadale MP 7/3/2016
Source: NHS Lothian January 2018