From the Scottish Government news website, today:
‘Backed by investment of £110 million in 2018-19 and jointly developed with the BMA, it will ensure GPs can spend more time with the patients who need them most by ensuring patients can access the right person at the right time. Over the next three years, it will expand the team of healthcare professionals working in general practice such as practice nurses, physiotherapists and pharmacists. A new short life working group, chaired by Professor Sir Lewis Ritchie, is also being established to ensure the contract is delivered in a way that works well for rural and remote parts of the country.’
When the Scottish contract was first introduced in January, the BMA contrasted it very favourably with that on offer in England and Wales. The BMA told the GP’s newsletter, Pulse (‘At the heart of general practice since 1960’), that the new Scottish contract is an ‘ambitious departure’ from the rest of the UK and that it will make the profession attractive again. See this from the Pulse report:
‘The 70-page document marks the most radical redrawing of general practice anywhere in the UK since 2004, with GP partners promised a guaranteed minimum income of at least £80k; direct reimbursement of expenses, longer consultations with more complex patients and the transfer of workload to the NHS with no loss of funding. But it is perhaps the whole theme of the document that is refreshing. The reassertion of the GP role as the ‘expert medical generalist’; the citation of Barbara Starfield’s ‘four Cs’ (contact, comprehensiveness, continuity and coordination) as ‘guiding principles’ and the whole emphasis on reducing workload and risk. It all makes the GP Forward View in England look rather cold and mechanistic, rather like a Haynes manual put next to a glossy brochure for a new car.’
Also speaking to Pulse, the Scottish GP Committee chair Dr Alan McDevitt said: ‘he was confident that the proposals would offer stability and make the profession attractive to young doctors.’
This comes at a time when GP numbers are falling fast in England with around 1 000 lost in one year despite the recruitment of 3 000 GPs from Europe and beyond:
Though the estimated headcount of GPs in Scotland has remained fairly static, the whole-time-equivalent (WTE) has fallen by 4%, from 3 735 in 2013 to 3 575 in 2017. However, the estimated WTE of registered nurses and health care support workers has increased by 9% and 33% respectively. This reflects and increasing tendency for GPs, many of them women with family-care responsibilities, to work part-time and for some of their duties to be taken over by the other professionals including pharmacists.
None of this can be interpreted as declining standards. Indeed, some surveys have shown greater patient satisfaction with treatment by nurses than by GPs.
Also, GP numbers per head of population remain much higher in Scotland than elsewhere in the UK. See:
Finally, readers will remember that evidence from 2015 suggests that Scottish GP practices were already the best staffed and that Scottish GPs seemed the least overworked or stressed in the UK: