A growing crisis for Fife GPs ...

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With more than a third of Fife’s GPs saying they are struggling to cope with their workloads and over 40 per cent revealing that they would not choose to become a GP if given the choice over again, it’s quite clear that there are major issues in the region’s primary care service.

The statistics come from a national survey sent out by the Liberal Democrats and set out in a paper entitled The Crisis in Scottish Primary Healthcare.

Quite a number of GPs are coming up for retirement and, because many are finding their workloads stressful, not many are staying on past 60

Dr Graeme Brown

Responses to the questions were recorded by 389 GPs around Scotland, including 38 from Fife.

Now a senior Fife councillor, with a long-established background in healthcare, has stepped in to call on the Scottish Government to intervene to tackle what he calls a “looming crisis” in Scotland’s primary care sector.

Councillor Tim Brett, leader of the Liberal Democrats on Fife Council – he was formerly chief executive at Ninewells Hospital in Dundee – said: “Most of us think of the health service as A&E and flashing lights and emergencies when, in fact, the backbone of it is the primary care GP service which deals with 90 per cent of people requiring medical attention.

“They are the ones who sort out most of our healthcare problems and only around one person in ten is transferred on to hospital services.

“Our GPs are the distinctive part of our health system and one of the reasons why we have such a good one.”

On the outcome of the survey, he responded: “I am grateful to so many general practitioners across Fife for taking the time to complete this questionnaire.

“Even though this report is based on a self-selected sample the large sample size provides confidence that it reflects opinion of general practitioners.

“The results are damning. More than 1 in 3 local doctors who responded to the survey said their workload was unmanageable.

“Sixty per cent would prefer to abolish the Quality Outcomes Framework of the Contract – the annual reward and incentive programme detailing GP practice achievement results – and two-thirds of the remainder want it reduced, while 42 per cent of respondents stated that they would not choose to be a GP again if given the choice.

“This report highlights the real pressures faced by local doctors here in Fife. It is to be regretted that the Scottish Government was unaware of the looming crisis in Primary Care and appears to continue to deny the existence of any crisis.

“My plea to the Scottish Government is to start listening to local GPs.

“Scottish Liberal Democrats support the Royal College of GPs’ plan for change. It addresses funding, infrastructure, IT, the GP contract, recruitment and integrated care.

“All of these are measures which must be considered by government immediately and urgently if we are to alleviate pressure on doctors in Fife.”

‘Domino effect’ impacting on surgeries

Dr Graeme Brown, senior partner at Bennochy Medical Practice in Kirkcaldy, said that there were major problems affecting practices not just in Fife but around Scotland.

“Quite a number of GPs are coming up for retirement and, because many are finding their workloads stressful, not many are staying on past 60.

“For various reasons, including the bad press they have been getting, there doesn’t seem to be as many people going on to GP training programmes, so there are not as many coming through.

“A lot of those who are female and many of those are looking for part-time work and that impacts on the total number of full-time equivalents coming through.

“In a number of cases there has also been a domino effect, whereby if a partner leaves a practice and they can’t get a replacement that leads to a lot more work for the remaining staff to deal with, and they start suffering from stress.

“The politicians are burying their heads in the sand when they say everything is fine in Fife. There is a practice in Kinghorn where the person retired and they are currently have great difficulty in replacing him and another in Methil where the practice had to shut and the NHS stepped in to keep it open.

“There are also difficulties in practices getting locums to provide cover if someone is off sick, again because there are fewer numbers coming through the training programme.

“We are lucky here at Bennochy because we have the advantage of being a training practice where trainee doctors come to get experience and because of that we have to meet certain criteria and have a higher standard of premises. The trainees get to know and like the practice and stay on, but those which are not involved in training are often not so fortunate.

“At the moment most Kirkcaldy practices seem to be coping okay, but that is not to say that it will still be the same in a few months time.”

New investment pledged

In June the Scottish Government announced details of how the Primary Care Fund would be used to support the primary care workforce, including GPs.

Over the next three years, £50 million will be invested to address immediate workload and recruitment issues, as well as putting in place long-term, sustainable change within primary care.

In addition, £10 million will be invested in primary care mental health services to encourage innovative ways of encouraging better identification and management of patients with mental health needs in the community.

Health Secretary Shona Robison said at the launch that new investment was the start of designing primary care services for the future.

She said: “These services play a hugely important role in looking after the health of the nation, and GPs in particular are vital in delivering frontline health care in the community.

“I acknowledge that many GPs find workload and recruitment issues challenging, and we’ll keep working with them to address this.”