Lothians GPs say staff shortages the root of problems at local practices

A GP recruitment crisis has created a postcode lottery of care for patients across the Lothians.
GPs say staff shortages are at the heart of many problems at local practices.GPs say staff shortages are at the heart of many problems at local practices.
GPs say staff shortages are at the heart of many problems at local practices.

A list revealing the 20 worst surgeries for GP access across Edinburgh and the Lothians has shown that as many as two-thirds of patients at some practices feel they cannot contact their GP in the way they want.

The 2017-18 NHS Health and Care Experience Survey, which had over 130,000 respondents from across Scotland, asked about people’s experiences with local health care and access to their GP surgeries.

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Results showed that across Scotland 87 per cent of respondents found it easy to contact their GP in the way they wanted, however this figure has been found to vary significantly across Edinburgh and the Lothians.

Some 66 per cent of patients surveyed from Dalkeith Medical Centre and Strathesk Medical Practice, in Bonnyrigg, for example, responded negatively to the question, ‘How easy is it for you to contact your GP practice in the way that you want?’.

Howden Health Centre, in Livingston, and Gracemount Medical Practice also saw over half of respondents to the survey claim they had difficulty arranging consultations.

The Chair of the British Medical Association Scotland’s (BMA Scotland) GP Committee, Dr Andrew Buist, argued that the problem was a lack of recruitment of GPs in a time of huge population growth.

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Mr Buist said: “Practices across Scotland are facing significant challenges recruiting and retaining staff at a time when the rising health needs of Scotland’s population is increasing demand on general practice to unprecedented levels.

“When practices cannot recruit enough GPs, it is inevitable that it becomes more 
difficult for patients to be 
seen as quickly as we all would like.”

Population across Edinburgh and the Lothians has seen an above average increase in recent years, with figures released last year projecting a 36 per cent rise in Midlothian’s population by 2041. Edinburgh and East Lothian’s populations are also expected to see a sharp growth over the next 20 years, with a projected 26 per cent increase.

Results from the survey also showed higher patient satisfaction in GP access among practices in rural, less deprived areas.

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St Leonards Medical Practice, on the Pleasance, Pathhead Medical Centre and Whitesands Medical Practice, in Dunbar, were found to be the top three best surgeries for ease of contacting your GP, with almost zero per cent of Health and Care Experience Survey respondents from those practices negatively replying to the question, ‘How easy is it for you to contact your GP practice in the way that you want?’.

A fall in the number of new GPs working full-time at practices is also said to be a contributing factor to these surgeries’ low rates of patient GP access satisfaction.

Some practices have began staffing more specialists such as nurses, physiotherapists and paramedics to take the strain off GPs, who are then able to deal with more patients suffering from more serious conditions.

Last year, Musselburgh clinics Eskbridge Medical Practice and Riverside Medical Practice merged and introduced ‘Collaborative Working for Immediate Care’, which took on a range of specialists to deal with its high volume of patients whose problems could be resolved without seeing their GP.

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Dr Buist said: “The new GP contract that came into place last year starts us on the road towards attracting more doctors to work in general practice and putting in place more community health professionals to support the work of GPs and meet people’s needs, but it will take time until these additional members of staff are in place.”

Dr Drummond Begg, a GP at Penicuik Medical Practice and chairman of the BMA’s Lothian local medical committee said: “We’re aware that GPs and nurses in Lothian are working incredibly hard. We’re aware of a gap between demand and capacity to meet that demand.

“Patients not just in these practices but in Scotland and the UK are frustrated by access to services.

“There is a new contract for GPs which will allow development of more staff to meet demand and with a combination of pharmacists, physiotherapists and advanced nurse practitioners we hope that services improve and are able to meet the needs of more people in the future.”