There must be an urgent and renewed focus on recruitment and retention of GPs, BMA Scotland said today as it published a survey of practices which demonstrates the huge challenges being faced.

The survey shows in stark numbers the level of activity GPs are grappling with – which suggests well above 500,000 appointments were provided in one week at the start of October. On these figures, that is the equivalent of 10% of Scotland’s population consulting with general practice every single week. All practices which were surveyed stated they were carrying out face to face appointments every day.

The BMA said there must also be an end to the abuse of GPs and their teams, as data showed this problem getting worse. All politicians across all parties need to state unequivocally that this is unacceptable and support that with honest messaging around what is possible for GPs at the moment.

The survey also found:

• 83% of practices said that demand was exceeding capacity – with 42% saying demand substantially exceeded capacity.
• Only 4% of those who responded said capacity was exceeding demand.
• 88% of practices said a member of staff had been subjected to verbal or physical abuse in the last month – 78% said this had worsened since the BMA last asked this question in May 2021, with only 1% feeling it had improved.
• More than a quarter – 28% - of practices which responded reported having at least one GP vacancy. Using this data, and applying it to the position across the country, BMA Scotland estimates there may be as many as 225 WTE vacancies across GP practices in Scotland.

Dr Andrew Buist, chair of the BMA’s Scottish GP Committee, said:

“It comes as absolutely no surprise that the vast majority of GP surgeries are saying there is simply not enough capacity to meet demand. Indeed 42% say capacity is substantially below what is required to meet demand for care.

“While this is in part, of course, due to increased demand, it is also clearly because we don’t have enough GPs. We have been saying this for some time, we believe it is now widely accepted and is why we have always welcomed the Scottish Government’s commitments to recruit the additional GP workforce.

“However, the need for this is significantly emphasised even further by today’s survey, which shows 28% - more than a quarter – of GP practices in Scotland currently have vacancies for one or more GPs. If that position is replicated across the country, practices are short of some 225 WTE GPs.

“We already knew we were desperately requiring additional GPs – so we welcomed the 2017 SG commitment for at least 800 more – the results of this survey make it all the more urgent. The commitment is there on all sides, but we need to see that backed up by a renewed focus on retention and recruitment of GPs so we can boost overall numbers. We cannot allow overall numbers in the GP workforce to stall as recent figures show they did between 2013 and 2019.

“In this context, and with the pandemic still well and truly ongoing – meaning we still need to protect vulnerable people and staff, and put in place effective infection control measures – it is not hard to see why there is huge pressure on GP appointments. To put it another way – the 500,000 appointments in general practice per week is still not enough to meet current patient demand in Scotland. That number of appointments is straining our workforce and GPs and their teams simply cannot sustain this indefinitely.

“I appreciate difficulty getting an appointment can cause understandable frustration at times – but it can never be acceptable when this spills over into abuse, which our survey shows is still happening and indeed may be getting worse. Almost nine out of ten practices report that staff members have been verbally or physically abused in the last month, and nearly 80% of practices say this abuse has gotten worse since May.

“We need to be absolutely clear, once and for all, that this is totally unacceptable and will not be tolerated. The Scottish Government has been extremely strong on this, which we welcome, and have worked closely with us to develop reasonable, open and honest messaging on face to face appointments. But we need all politicians to go on emphasising the position. No one – and least of all those people in caring services – should face abuse for doing the best they can in the extremely trying circumstances set out above.”

Notes to editors

We received 375 responses to this survey – which accounts for 41% of GP practices in Scotland, with a patient roll of 2,592,804, which makes up 45% of the total number of patients registered with GP practices in Scotland.

In the week from 4-8 October 2021, there were a total of 221,420 consultations completed at the practices who returned the survey – if the same rate of consultations to number of patients was applied to the total population of Scotland, more than 500,000 appointments would have been held in a single week in general practice.

Every single practice surveyed was carrying out face to face appointments daily.