Friday, 12 August 2016

More data On GP capacity - this time city wide

Recently I have posted several times about local GP capacity - see here and here and here.

As I know some are very interested/concerned about the issue I include below in full a recent briefing which has been supplied to me by the SW Locality Manager:
"GP capacity and primary care pressures

Current situation

There have been concerns expressed nationally about the sustainability of primary care / GP provision for several years.
. . . click title for full post . . . 

GP practices are independent businesses which hold a General Medical Services (GMS) contract awarded by the Health Board. Many have held these contracts uninterrupted since 1948 and have always been considered a very stable part of public service provision. They are not a managed part of the organisation and can return their contracts at which time the responsibility for the provision of GMS falls to the Health Board and now the Health Board/ Integration Joint Board (IJB).

In Edinburgh, these concerns first became apparent in 2014 when four GP practices experienced difficulties in sustaining their service. The circumstances differed but included a small practice closing and another requiring support and the redistribution of 2,000 patients to alternative practices.

A number of other practices have subsequently requested support, additional management attention and/or additional resources. Restricted patient lists are also indicative of pressure on GP resources and, as of August 2016, 30 of 73 Edinburgh practices are operating restricted lists.

However, it is important to note that the majority of GP practices in Edinburgh remain stable, including many of those with restricted lists.

Reasons for instability

·         There is a national shortage of GPs.
·         Many younger GPs are unwilling to take on the responsibility of partnerships.
·         Across the UK a disproportionate number of GPs are in the last 5 years of their substantive careers.
·         Since 2009, Edinburgh has seen a steadily growing population, with population increasing by an additional 5000 people per year. This trend is set to continue.
·         A lack of investment in infrastructure over the years has left many GP practices with unsuitable / poor accommodation which limits expansion and plans for increased provision which do not match the population growth.

Actions undertaken to date

A successful programme of small grants to GP practices willing to expand their list size by 500, together with small and medium capital schemes have helped to avoid crisis in 2014/15 and 2015/16.   A recent report detailed that an investment of £800K during 2014/15 and 2015/16 had secured additional capacity for 13,500 additional patients and facilitated actual growth for c10,000 patients over these two years.

NHS/ Health and Social Care Partnership staff are working closely with GP practices that are experiencing current difficulties to stabilise practices and ensure patient safety.

New practices have recently been established in Leith and Craigmillar to cope with population growth and there is investment in new premises in Oxgangs/Fairmilehead and Muirhouse.

The Integration Joint Board is developing an increasingly close relationship with the CEC infrastructure programme to ensure that opportunities for future development are explored as the City infrastructure responds to population increase.

Next steps

The outcome of the Local Development Plan consideration by the Scottish (Government) Report will be known later this month. This will allow adjustment of current assumptions about the location or timing of particular population pressure points.

A new national GP contract is being negotiated to be implemented from 2017. This will be designed to improve stability and may include premises specific measures.

The Integration Joint Board which brings together NHS and CEC resources is well placed to formulate a long-term, ambitious strategy to support primary care, stretching beyond the current difficulties."

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