Scottish Government 'unlikely' to hit GP target, watchdog finds

The Scottish Government is "unlikely" to hit its target of delivering 800 more GPs by 2027, a watchdog has found.

Audit Scotland said a seven-year-old deal to improve general practice has "failed to deliver" on key commitments and a workforce pledge is likely to be missed.

Agreed with the relevant arm of the British Medical Association (BMA) in 2018, the general medical service contract was aimed at tackling financial pressures and workloads for GPs.

It was also intended to improve patient access to care.

But pressure on general practice has been found to have increased and people report finding it "more difficult" to see doctors.

Published today, the Audit Scotland report also found the estimated number of whole-time equivalent GPs is down, the proportion of NHS cash spent on general practice has dipped in real terms, and progress on the provision of more nurses, physios and other specialists has been slow.

National data for primary care remains inadequate, the watchdog said. There is a lack of robust information about general practice demand, workload, workforce, and quality of care. This limits the Scottish Government’s ability to say whether the GMS contract changes represent value for money or have improved patient care, it is claimed.

Stephen Boyle, the Auditor General for Scotland, said: "The pandemic pushed back plans for general practice. But the new delivery deadlines that were put in place were missed and there's not been enough transparency about progress since then.

"The Scottish Government needs to clarify its plan for general practice and set out the actions, timescales and costs to deliver it."

The report found outstanding commitments from the contract included the expansion of multi-disciplinary teams in priority services. There were "significant gaps" in the implentation of such teams, and a "lack of clarity" around the investment needed.

Though ministers have committed to increasing investment in primary care by 25 per cent by the end of the parliamentary term, it is unclear how much of this will go to general practice.

Dr Chris Provan of the Royal College of General Practitioners (RCGP) Scotland said the findings "will not come as a surprise to any GP", claiming general practice "has felt to be in a state of perpetual crisis following years of underinvestment and systematic neglect".

He said: "We wholeheartedly agree with the recommendations set out in the report; indeed, many of these are things that we have been asking the Scottish Government to take action on for years.

"With proper support, recognition and investment, general practice is the solution to preserving the NHS for future generations."

Labour health spokesperson Jackie Baillie said that "rather than providing a clear direction, the 2018 contract has disempowered GPs and betrayed the patients it was supposed to serve".

Her Tory counterpart Dr Sandesh Gulhane said general practice had been "abandoned" and called on health secretary Neil Gray to "ensure money gets to frontline care rather than being wasted on pointless bureaucracy".

Responding to the report, Gray said "many of its recommendations are already in progress" and the Scottish Government was "committed to working with the BMA to support general practice and to meet our commitment to deliver 800 additional GPs by 2027".

He went on: "The first minister and I have been clear that we know too many people have had issues with seeing their GP and we have set out a plan to improve access, with a greater proportion of new NHS funding going to primary and community care so that GPs and services in the community have the resources to play a greater role in our health system.

"This financial year we have invested an additional £73.2m in general practice, including £13.6m to support GPs, and the 2025-26 Budget includes over £2.2bn investment in primary care which will help to make it easier for people to see their GP."