Thousands in Lothian at risk of being left without a doctor

GP services across Lothian are at crisis point. Picture: Anthony Devlin/PA Wire
GP services across Lothian are at crisis point. Picture: Anthony Devlin/PA Wire
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THOUSANDS of people across the Lothians are at risk of being left without a doctor due to over-stretched practice lists as the GP crisis continues to grow.

A report by the Edinburgh Integration Joint Board lays bare the scale of the problem and warns that a rising population need to be able to register with a GP or the system will break down.

At present, 43 out of 73 GP practices in the city are restricting patient registrations.

The situation is so bad that both Hibs and Hearts have offered to host medical practices within their grounds.

The Evening News reported last month that more than 40 per cent of GP practices in the Lothians are now imposing ­restrictions on patient access – a rise of 17 per cent in the last year.

Estimates suggest 618,978 people will live in Edinburgh by 2037, compared with 498,810 in 2015, a rise of more than 120,000 in just over 20 years.

Difficulties in recruiting doctors has pushed practices to restrict their patient lists.

The report on the future of GP premises reveals the true extent of the pressure being placed on the current system.

For example, among surgeries that have opened since 1999 the original list size was for a maximum capacity of 64,421.

But that has been exceeded and these practices now cater for 80,403 people.

A total of five GP practices have closed in Lothian over the last three years, the latest being the Inverleith Medical Practice which shut its doors in June and catered for 4000 patients.

The Greens health and social care spokesperson Cllr Melanie Main said: “There are some chickens coming home to roost for NHS Lothian, after years of failure to invest in GP surgeries and in the services within them.

“The city, and the wider region, is now faced with a massive backlog of investment.

“We know now where the gaps lie – the task ahead is to make good years of under investment.”

She added: “The council and other public agencies also have a role to play, working with others like voluntary organisations.

“In the Green manifesto for the council elections we highlighted the way in which the council could host GP services in its buildings or even directly employ GPs.

“That is also true of some major city institutions: for example, Hibs and Hearts have both indicated willingness to host public medical services within their stadiums.”

There are no formal “closed” GP lists at present in the Lothians as this requires an application process and NHS board consent.

The report stated that during 2017-18 several schemes require progression to “avert service failure”.

This refers to specific practices that needed to be relocated as a result of issues with their premises, such as leases expiring. The failure here would be if a practice had no building to operate from.

The report continued: “If a growing population are unable to register with a GP, the current uncomfortable but accepted system of ‘allocation’ to practices will almost certainly break down. This would quickly lead to several thousand people being unregistered with a GP and a consequent reliance on emergency services.”

The allocation system is where the health board allocates patients who cannot register at their local GP to a different neighbouring GP practice. But this process only works when there is capacity in GP surgeries in different areas next to practices with closed lists.

Edinburgh Southern MSP Daniel Johnson said: “These revelations confirm what we have known for months – there is a GP crisis in Edinburgh and the Lothians.

“The idea that thousands of patients could be left without a GP would place an intolerable strain on our healthcare system.

“GPs represent the front line in healthcare, and should that break we know it will place even more pressure on already stretched hospital and emergency staff.”

Every NHS board in Scotland is obliged to provide a patient with a GP.

However, restrictions can apply to choice and often mean people do not have access to a doctor in their catchment area.

Scottish Conservative health secretary, Miles Briggs said significant investment was needed in new and expanded GP practices across Edinburgh to avoid a “meltdown”.

He said: “The Edinburgh GP premises report contains numerous stark warnings about just how much strain there is on GP services across the city and how these pressures are going to increase as the area’s population continues to rise sharply.

“It is clear significant investment is needed in new and expanded GP practices across Edinburgh if we are to avoid a meltdown in GP services which would lead to additional pressures on emergency health services.”

David Small, Primary Care Policy Lead, NHS Lothian, said: “Like all GP practices across the country, those in Lothian are facing considerable challenges in recruiting new doctors.

“Restricting the number of new patients who can register at a practice is a temporary measure that allows practices to cope with pressures and ensure they can continue to provide a safe and effective service.

“This is a decision which is never taken lightly and in the longer-term we are working closely with all four health and social care partnerships and local GPs to provide advice and support, and to enable restrictions to be lifted.”