East Renfrewshire’s GP surgeries are facing a “very challenging” time with “summer pressures” impacting on service delivery.
Dr Claire Fisher, clinical director at East Renfrewshire’s Health and Social Care Partnership (HSCP), said the pressures include a shortage of locum GPs, staff on annual leave and covid.
The director added a Scotland-wide target of 800 new GPs possibly “won’t be enough at the moment”.
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She was speaking at a meeting of East Renfrewshire’s integration joint board – which directs the HSCP, a partnership between the council and NHS. East Renfrewshire has 15 general practices with a patient population of over 98,000.
Council leader Owen O’Donnell asked the health boss whether there was quantitative data, the “equivalent of an A&E waiting time”, on the “ultimate objective of easing strain on GPs”, such as “time to see a GP”.
“It’s hard to see what the quantitative impact is and obviously anecdotally I’m still getting text messages from my practice saying ‘emergency only’ on certain days,” he said.
“There is still a lot of strain clearly on GPs.”
In response, Dr Fisher said it was “difficult” to get the data in primary care as “we work on different software systems and things like that”. She later added it can be “a bit of a challenge” to provide data when “you’re at the coalface and you’re firefighting”.
The director said it has recently been publicised about Scotland being short of GPs. The Scottish Government has a campaign to increase the number of GPs by 800 by 2027.
She added: “We are all aware that although the 800 GPs would go some way, certainly given the landscape and the workload pressures that we are all facing on a daily and weekly basis, probably won’t be enough at the moment.”
Dr Fisher said herself and colleagues had been asked their opinion by the Scottish Government on “where the 800 GPs should be aligned”. “I think in East Renfrewshire we certainly had a significant population growth and I had certainly suggested that perhaps some of these GPs should be aligned to areas where there was significant growth,” she said.
The director also said the pressures go “wider than just GPs” with a “shortage of traditional practice nurses as well”. “You highlight the message coming from practices, I think everyone will be aware of what we call winter pressures in the NHS. It’s the cold season, lots of respiratory viruses, that usually starts around November time into February/March.”
She added now there are “summer pressures” for general practices as “staff who have been working very hard are being encouraged to take their annual leave, there’s a shortage of sessional locum GPs to cover, so there’s lots of different factors why as well as another [covid] wave, that we’re just coming out of, that a practice might be able to offer a certain service one day but might have to reduce that to emergencies only given staffing pressures”.
“It’s a very challenging time for general practice. The HSCP, I meet with the practices regularly through the GP forum and also through their local cluster meetings and we are working hard with colleagues just to support practices as best we can.”
On collecting data, Julie Murray, chief officer of East Renfrewshire’s HSCP, said: “We’ve got a number of practices that regularly provide the data around access and around how many face-to-face appointments, how many telephone, how many video but we haven’t got that across the piece.”
She said it was “not a local issue, it’s a national issue” and “something the health board is very keen on trying to pursue as well”.
Dr Fisher was reporting on the impact of a primary care improvement plan and a new multi-disciplinary team had had on patient care in East Renfrewshire. When a new contract for the provision of general medical services in Scotland started in April 2018, it envisaged the development of multi-disciplinary teams of health professionals employed by HSCPs to support GPs.
The aim was to free up clinical time to allow GPs to “take on a role as expert medical generalists, and allow them more time to care for patients with the most complex needs”, Dr Fisher reported. By June this year, an additional 52.5 whole time equivalent staff had been employed to support practices.
The report added: “The impact of the pandemic on General Practice has been really significant and the current pressures and sustainability challenges which practices are reporting are very much linked to the pandemic rather than a failure of impact of the PCIP [improvement plan].
“Practices in East Renfrewshire have absorbed a significant increase in list size due to new housing developments, and are now providing services to a larger number of people. The additional MDT capacity has supported that increase as well as the management of existing workload in a sustainable way.”
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