Now GPs demand a daily limit on the number of patients they see amid staffing crisis

• Doctors told to cap appointments at 25-a-day and let NHS24 and A&E deal with the rest
• Senior medics say surgeries are being overwhelmed and staff left ‘exhausted and over-worked’

By Kate Foster For The Scottish Daily Mail[1]

Published: 00:13, 4 December 2023 | Updated: 00:13, 4 December 2023

Scotland’s GPs have been advised to put a daily cap on the number of patients they see.

The controversial guidance from the British Medical Association Scotland comes as GP surgeries struggle to cope amid staff shortages.

Family doctors have been told that it is not their ‘responsibility’ to see patients if other NHS[2] services are too busy to deal with them.

Clinics across the country are having to deal with dwindling doctor numbers and increasing demands from patients with complex health needs.

Dr Andrew Buist, chair of the British Medical Associations GP Committee, has warned that demand is outstripping capacity at surgeries and the new guidance is aimed at protecting staff

Scottish Tory health spokesman Sandesh Gulhane, who is also a GP, blamed the SNP for mismanaging the NHS and warned patients would suffer from appointment limit

The guidance means doctors are now expected to limit their appointments to just 25 a day, with patients over that capped number directed by answerphone message to NHS24 or A&E.

Dr Andrew Buist, chair of the BMA’s Scottish GP committee, said: ‘Demand is far outstripping GP capacity… which is why BMA Scotland refreshed its safe working guidance – highlighting the other health board services available to patients – to safeguard the profession, protect practice staff and, crucially, improve the experience of patients who deserve to be seen by a doctor who is not exhausted and overworked.’

Last night critics warned patients would suffer unless under-fire Health Secretary Michael Matheson can ‘step up’ and support the service.

Scotland needs at least 800 more GPs by 2027 and doctors’ leaders have been warning for years of a worsening crisis in the service.

Practices are collapsing because they cannot recruit new partners, and patient care is suffering.

Scottish Conservative health spokesman Sandesh Gulhane, who is also a part-time GP, said: ‘This latest guidance shows how it is patients, and other areas of Scotland’s NHS, who will suffer the consequences if the discredited Michael Matheson does not step up and support us as burnout runs the risk of more GPs leaving the profession.’

The BMA Safe Workload Guidance for GPs in Scotland says that having an ‘unmanageable workload’ is the number one problem in the working lives of doctors.

It adds: ‘It is also harming the experience that patients have with their practice.

‘We recommend practices take urgent action to preserve patient care and their own wellbeing.

Practices will need to decide how to prioritise care and day-to-day activity accordingly.

These actions will inevitably result in some patients waiting longer, or issues that do not need to or cannot be dealt with in general practice being directed elsewhere.

‘Health boards are ultimately responsible for the provision of primary medical services for patients.

GP practices are not a safeguard for all NHS services or providers of last resort – and they cannot be expected to operate beyond the terms of their contract or undertake a workload that is unsafe.

If other services are unable to see patients, that is not the responsibility of the GP practice.’

When surgeries cannot take more appointments, the BMA recommends diverting calls to an answerphone message directing patients to ‘other NHS agencies, including NHS24 on 111 or through accident and emergency’.

It adds that a ‘safe’ number of patients per GP is 25 a day, including a mix of face-to-face and remote consultations, and that doctors should hold 15-minute appointments.

Previously GPs have warned they are dealing with 50-80 patients a day.

John O’Connell, of the TaxPayers’ Alliance, said: ‘Directing people to A&E when they may not require urgent care could clog up an already struggling system.’

The Scottish Government said it was ‘up to individual GP practices to decide how many appointments their partners and salaried GPs need to provide’.

References

1. ^ Kate Foster For The Scottish Daily Mail (www.dailymail.co.uk)
2. ^ NHS (www.dailymail.co.uk)