The Scotsman

Innovative and imaginitiv­e policies required to relieve the burden placed on GPS

Doctors across the country have been operating in a difficult environmen­t long before Covid-19 ever entered our lexicon, writes Andy Drane

- Andy Drane, partner and GP practice adviser, Davidson Chalmers Stewart

The pandemic is taking a serious toll on UK healthcare sector profession­als, including GPS, who are under increasing pressure due to remote patient contact, staff absences and a backlog of treatment for non-covid ailments.

A poll published near the end of 2020 in Gp-online revealed that 81 per cent of GPS had seen their workload rise since the pandemic hit, with a third describing workrelate­d pressure as 'very high'. The situation is unlikely to improve with the UK managing a second wave of the virus.

GPS have been operating in a difficult environmen­t long before Covid-19 ever entered our lexicon. While the added pressure brought on by the pandemic has triggered an immediate crisis for those within the profession, none of the legacy issues have gone away either, presenting a wider threat to public health and wellbeing.

Asgps continue to get older, there aren’ t enough newly-qualifiedc­andidates emerging as replacemen­ts, nor will there be for some years to come. training more doctors takes years. while some uk doctors have postponed retirement to help during the pandemic, for others it’s hastened their plans to step down. With the second wave of covid placing even greater burden son the profession, I would anticipate that once they get the chance to draw breath, significan­t numbers of gps will decide it’s time to move on.

Here in Scotland, the challengin­g task of GP recruitmen­t has been further complicate­d by the Scottish Government’s attempted integratio­n of health and social care alongside the implementa­tion of its new GP contract. Under the new agreement, GP practices will continue to operate as private businesses with the partners’ remunerati­on dependent on their level of profitabil­ity. Policy underpinni­ng the new agreement is supposed to offer further Government support by removing elements of the risk of running a business from GP practice partners, allowing them to focus more clearly on meeting patient needs. As well as making more funding available, the new GP contract also reinstates the principle that doctors are expert medical generalist­s supported by a raft of healthcare profession­als and should therefore only focus on those patients who actually need to be seen by them. At least that’s the theory.

However, if Scotland is to avoid post-covid GP shortages, further actions will be essential. Creating a vibrant and stable working environmen­t for GPS and other healthcare profession­als is a critical part of addressing improving the country’s underlying health issues. Along with ensuring that all health Boards take a consistent approach in implementi­ng the new contract, the scottish government must also deliver on its key support policies.

Meanwhile, the conservati­ve government at Westminste­r needs to focus onuk-wi de issues which prevent older, experience­d GPS from working. The Chancellor’s March 2020 budget took some steps towards addressing aspects of the pension crisis where currently doctors’ earnings are super-an nu able at fixed percentage­s. Covid has diverted debate from these steps but issues still remain,lifetime allowance limits.

Incentivis­ing medical students into a career within general practice is also needed along with rules requiring Uk-trained doctors to remain working here for a minimum period after qualifying.

The post-covid world represents real opportunit­ies to reimagine how services are delivered. Challengin­g as the pandemic has been there has been new learning for everyone, the health sector included. the strain ongps is likely to continue beyond covid if policy makers fail to deploy innovative and imaginativ­e policies that reduce the increasing burden they’re facing. Given the essential front line role of GPS in promoting public health, it is a challenge which must be met with vigour and urgency.

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