A survey carried out by BMA Scotland found 30 practices described their position as "precarious" following the pausing of the GP Sustainability Loan Scheme.

Of these, six said having to hand back their contract was "likely" – meaning health boards would have to take on responsibility for provision of GP services, potentially impacting patient choice and access.

GPs who responded to the survey commented that they have been "left in limbo", that it is "hard to see how we can survive" and say they feel "deeply disappointed and let down" by Scottish Government’s decision to pause funding.

More than eight out of ten of respondents – 47 out of 55 - said that if they did receive the loan it would considerably improve their stability.

No respondents said that contract termination would be likely if the funding was in place.

Under the scheme, which was a key part of the 2018 GP contract, GPs who own their own premises can apply for long-term interest fee loans worth up to 20% of the practice’s value, which is only repayable when the building is sold or converted to non-medical use.

Health boards are also given first option to purchase the premises, with one of the aims of the scheme a long-term move to a model where GPs are not required to own or provide their own property.

It is also aimed at easing the financial burden of owning a practice, reducing some of the up-front costs GPs can face when joining a practice and in turn improving recruitment and retention.

Comments from GPs on the suspension of the loan scheme in the survey included:

• "It leaves us in limbo now."
• "Increasing building and staffing costs may lead to staff redundancies."
• "It is hard to see how we can survive."
• "Our future is now binary – high probability of collapse of…practice without loan completion and all but certain future with it in place."
• "Without the sustainability loan, we fear we will not be able to attract new partners and that the existing partners may leave."
• "Feel deeply disappointed and let down."

Dr Andrew Cowie, Deputy Chair of BMA Scotland's GP Committee, said: "We have been hearing many concerns from GPs over the pausing of the sustainability loan scheme; and this alarming survey reveals the huge impact even a short delay may have on practices that are already under pressure with inadequate workforce and resource to meet the needs of the communities they serve.

"The scheme provided vital support to ease the financial risks of owning GP premises and increased the stability of practices, improving recruitment and retention of GPs.

"Indeed, the Scottish Government said in 2019 it would contribute to its commitment to increase the number of GPs in Scotland by at least 800 over the next decade.

"But the decision by ministers to now pause sustainability loan applications will destabilise surgeries and put at risk quality and continuity of care in many places. In some case it may even see practices close.

"Owning a practice can make it difficult to replace retiring partners and the inability to recruit a new partner makes collapse and contract termination much more likely.

"We are in the middle of a medical workforce crisis and GP shortages mean there already are not enough GPs to meet the needs of the people of Scotland.

"Scotland has lost around 100 GP practices over the last ten years - and it is clear we cannot afford to lose even one more.

"The Scottish Government must restart the loan application process immediately before it is too late."

 

Notes to editors

• The findings are based on a BMA Scotland survey of GP practices carried out in April which received 55 substantive responses. A further 77 had either had not applied for a loan or did not give substantive answers.
• Sustainability loans were introduced as part of the 2018 GP contract (p6)
• Scottish Government news release 15 February 2019 - £50m support for GP practices