RCGP Scotland response to Primary Care Out of Hours Workforce Survey findings
Publication date: 20 February 2023
Responding to this week’s Primary Care Out of Hours Workforce Survey findings, RCGP Scotland Joint Chair Dr David Shackles said:
"RCGP Scotland notes with disappointment the results of the recent Primary Care Out of Hours (OoH) Survey. Our Out of Hours GPs are an incredibly important section of the primary healthcare landscape. It is highly disappointing that the majority of NHS Boards reported decreases in the number of GPs working for Out of Hours services compared to 2019. During the Out of Hours operating period, these services see more patients than A&E, and so it is important to ensure sufficient levels of staffing to meet need. Patients deserve an effective and reliably resourced Out of Hours service.
"General practice has been facing very high levels of demand, sustained over long periods. GPs are not contractually obliged to work in the Out of Hours service, and with these pressures being experienced during in-hours general practice, many report not feeling able to work in OoH too.
"As noted in the report, eight NHS Boards have had to take additional action at least weekly to ensure shifts are filled through a variety of rostering and other means. This demonstrates the worrying state of affairs for Out of Hours services across Scotland. It is crucial that Out of Hours general practice be a place where GPs and other doctors feel supported, not overwhelmed, and can work safely. As demonstrated in the survey results, older GPs work a disproportionate number of hours (and 9% do almost half the work) in Out of Hours services. As these GPs retire, it will be essential to retain and recruit a sufficient number of GPs, moving forward. There are no contingencies should Out of Hours services collapse, and so every effort must be made by the Scottish Government to ensure the continued operation of the Out of Hours service.
"The College has called for a number of measures to improve the situation in its recent report on retaining the GP workforce (PDF file, 1.1 MB). These include better support and opportunities for training, addressing pensions issues and reviewing progress round the recommendations of Scottish Government’s 2015 independent review into primary care Out of Hours services. 1 There is an urgent need to address daytime issues of workforce and workload too.
"It is imperative that every OoH service has defined and sufficient senior GP leadership posts as well as options for salaried doctors to work in the Out of Hours service - with protected time for learning and training intrinsic to those sessions. Continued long term mechanisms for experienced GPST3s to undertake sessions in the service and consideration for other specialties with a generalist focus to participate are also needed. Up-to-date data on Whole Time Equivalent (WTE) GPs would enable a better understanding of the current Out of Hours workforce and its pressures, to underpin workforce planning and allow us to monitor progress against commitments.
"With adequate resources and planning, improvements to daytime working and changes to pensions, stability in the Out of Hours service is achievable. We need to see significant and sustained efforts as well as long term strategic planning from the Scottish Government to address the profound issues currently facing primary care."
Media requests to Angus Gould
RCGP Scotland Policy and Public Relations Officer
Tel: 0203 188 7737
Notes to editor
RCGP Scotland represents a network of around 5,000 doctors in Scotland aiming to improve care for patients. We work to encourage and maintain the highest standard of general medical practice and act as the voice of GPs on resources, education, training, research, and clinical standards.