The BMA in Scotland is warning that GPs will not be able to take on more work without more resources, including significant investment in infrastructure.
In its response to a Scottish government consultation on integrating health and social care, the BMA calls for a comprehensive assessment of the likely resources required in primary and secondary care to meet the needs of a growing elderly population.
‘Without adequate planning and investment for both sectors Scottish government aspirations to shift the balance of care and integrate adult health and social care may not be achievable, and general practice could buckle under the strain of an impossible and unsustainable workload,’ the BMA warns.
Under the government’s proposals — which will form a bill to be introduced this session — community health (and care) partnerships will be replaced with new partnerships to plan and run services for local areas.
The BMA calls for greater clarity on how the role of clinicians in the strategic commissioning of services will be strengthened.
Potential for problems
‘Without this detail on how clinicians will influence service delivery there is a considerable risk that previous mistakes will be repeated,’ the BMA says.
When looking at outcomes, the BMA says that measures of benefits must be evidence-based if doctors are to be engaged with the process. ‘An inability to demonstrate the centrality of these benefits will create a barrier to doctors’ involvement,’ the BMA says.
On finance, the BMA says while NHS services are free at the point of delivery, some social care services are charged for on an individual basis.
The association adds: ‘We urge … clarity about which services will be provided by the NHS, and to ensure that no funding is moved from the NHS into services provided by commercial and voluntary providers.’
The BMA also calls for more explicit examples of how integration will work, saying there is a lack of detail in the consultation.