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Scottish GP leaders call for debate on future of general practice

4 March 2009

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Scottish GP leaders are calling on the public to get involved in developing policy for the future of NHS general practice in Scotland.

BMA Scotland yesterday (Tuesday 3 March 2009) published a new consultation document to encourage debate and discussion on a long-term strategy for general practice.

It says rising patient expectations, increased demand for access to GP appointments and limited opportunities for newly qualified GPs, are just some of the challenges facing Scottish General Practice today. BMA Scotland is keen to hear what the profession and patients believe are the key priorities for action.

Dr Dean Marshall (pictured), chairman of the BMA’s Scottish GPs’ Committee, said: “We welcome the Scottish government’s commitment to NHS general practice. It is our view, however, that there is a pressing need to develop a strategy for general practice in Scotland that can deliver on the Scottish government’s health policies.”

The consultation document, General Practice in Scotland: The Way Ahead, considers six areas that GPs consider require the most urgent attention:

  • Improving access to services.
  • Developing the right workforce.
  • Reducing health inequalities.
  • Shifting the balance of care.
  • Providing out-of-hours care.
  • Improving premises and information technology.

Dr Marshall said: “Every year, more than 23 million consultations take place in GP surgeries across Scotland. For most patients, general practice is the first and only point of contact in the NHS system.

“We recognise that the public wants greater access to GP services but this cannot be achieved within the current structures and resources. By consulting on these issues, I hope that we can have a sensible debate about what NHS general practice can deliver and where we need to adapt to become more responsive to our patients.

Extracts from the consultation document include:

  • “Some patients report problems in getting appointments that suit them. Patients tell us they find systems for ‘same day’ appointments frustrating,” says the BMA. At a national level, options to overcome this problem could include delivering a public information campaign about responsible use of NHS services, increasing the number of GPs and reducing GP list sizes to create more capacity.
  • “GPs already make an important contribution in helping to reduce health inequalities. However, working in deprived, socially marginalised areas is very demanding. This needs to be recognised and resourced to attract more GPs to work in these areas”. The BMA suggests options such as providing additional resources to practices in these areas, increasing training opportunities in deprived communities and investing in GP premises.
  • “Patients in Scotland should receive a high quality, seamless out-of-hours service that is safe, reliable and efficient,” states the document. Options to achieve this include increasing GP involvement while maintaining the current NHS 24 service; retaining NHS 24 as a telephone answering service but devolving funding for out-of-hours services to NHS boards to provide the service; and dismantling NHS 24 and transferring responsibility for the service to NHS boards.

BMA Scotland