The Royal College of General Practitioners (RCGP) Scotland is calling for wider recognition, investment and engagement with GPs to sustain and expand the ‘immense contribution’ they make to patients, communities, the NHS and the wider economy.

A new report published by the College outlines seeks to challenge a ‘cycle of invisibility’ faced by community health services, and highlight the unique training, experience, compassion and relationship-based care they offer.

RCGP Scotland sets out how building strong relationships with patients is key to improving health outcomes and even lowering death rates, especially for trauma survivors, the elderly, marginalised communities and those impacted by socioeconomic deprivation.

However, the report states that this continuity of care approach is ‘underprioritised’ and at risk in Scotland, unless staffing and funding is increased to allow GPs protected time to plan care with their wider practice team.

Protected funding and time would allow GPs to focus on service improvement and avoid the care fragmentation which sees ‘patients slipping through the cracks’.

Laying out the economic case for policymakers, the paper highlights that an investment of £1 in primary care brings £14 of extra growth in the wider economy.

‘Invisible, frustrated and undervalued’

In his foreword, RCGP Scotland Chair Dr Chris Provan says he is ‘frustrated’ to see the funding received by primary care not reflect their importance.

It comes after Scotland’s clinicians questioned the ability of GPs to deliver 100,000 additional appointments pledged in the Scottish government’s programme for government. 

Dr Provan told healthandcare.scot that while challenging it is a “privilege to help patients” but with rising demand on primary care services, change is needed to sustain general practice – and by extension the NHS:

“There is no doubt this unresourced increase in workload has damaged morale, deterred medical students, and led to many practitioners leaving the profession early. 

“If these patterns of a decline in the workforce and underinvestment continue, market forces could direct the growing patient need away from the family doctor and towards a less efficient and holistic model. 

“Without general practice the NHS as we know it could not exist. We are here to help – GPs are the solution to the NHS crisis.”

Dr Provan adds that the wider GP team is essential to this, emphasising the role of pharmacists, physiotherapists, practice nurses and link workers in delivering increasingly community-based care.

He calls for healthcare professionals and policymakers to ‘resist’ transactional medicine and deliver a system which both uses its resources efficiently and puts human connection at the heart of care.

This comes the same week as Holyrood’s Public Audit Committee heard evidence on an Audit Scotland report, which detailed the failure of Scottish government to meet many of its commitments over financial and workload burdens facing GPs.

MSPs heard from the Auditor General that poor workforce planning and a lack of investment to grow the GP workforce has led to significant variation in access and a fall in the number of fulltime equivalent GPs.

The RCGP Scotland now seeks a ‘bold’ response from policymakers to its new report that delivers more resources to GPs and a long-term strategy that will help general practice reach its potential for patients.

Dr Provan said it is “more important than ever” to celebrate the wide-ranging contributions of GPs to the health system and wider society: 

“No one can deliver what GPs do, as well as GPs do. It is GPs who protect the wider NHS by preventing ill health from worsening to the point where hospitalisation is required.  

“It is GPs who lead teams that deliver 90% of patient contacts on any given day with just a fraction of the health service budget.

“And it is GPs who develop long-term relationships with patients and the wider communities they serve built on trust, which benefits both practitioner and patient.” 

Dr Provan said if policymakers can learn from RCGP Scotland and other health leaders to “turn positive rhetoric and promises into real change” for GPs, patients and the wider healthcare system will benefit.

He added:

“There will always be a need for general practice, but if we don’t change course, the form it takes is open to question.”

Read more: NHS doctors unemployment crisis despite understaffing; First Minster pledges people will see GP sooner; Watchdog criticises homelessness health service cuts; GPs to lead on NHS frailty plan; Racism driving social workers to consider leaving; GPs in ‘moral distress’ over drug shortage; NHS is not a ‘political football’; Scheme for GPs to help lost patients; Labour: We'll fix the NHS, starting with GPs