Three professional bodies representing clinicians working in Scottish primary care are calling on the Scottish government to consider alternatives to GP walk-in centres to improve patient access to healthcare.

Ahead of the unveiling by the First Minister this week of the Programme for Government for the coming year, the Royal College of General Practitioners Scotland, Royal College of Pharmacy (Scotland) and the Chartered Society of Physiotherapy Scotland have issued a joint statement setting out what they say are ‘practical alternatives’ to the new centres, which will deliver the improved access for patients that minsters are promising.

The three organisations say they recognise that too many patients currently experience difficulties accessing care when they need it, but say GP walk-in centres are not the answer.

Earlier this year, the Royal College of General Practitioners Scotland (RCGP Scotland), and BMA Scotland appealed to ministers not to continue to pilot the walk-in model which, they said, had already failed in England where it had led to costly duplication of services, exacerbated health inequalities, and destabilised existing local healthcare services.

Last week, First Minister John Swinney marked the official opening of the 11th GP walk-in service, in Buckhaven in Fife, by announcing a new target of 40 services to be up and running by April 2029.

Speaking at the new centre at Randolph Wemyss Community Hospital, Mr Swinney said:

“I promised that my government would break from the status quo and introduce a new way for patients to access same day care – and we are delivering on that commitment. We are listening and want to create more choice for patients, closer to home and without the need for a pre-booked appointment.”

He added:

“This is part of my government’s wider agenda to provide patients with greater choice and access to care closer to home – in turn relieving pressure on hospitals and acute services. It will complement our trusted network of GP practices across the country, which we are bolstering with historic additional investment to recruit more GPs with £531 million to 2029.”

Opposition MSPs say the numbers attending the walk-in services so far suggest take up has been poor.

Scottish Liberal Democrat health spokesperson Adam Harley MSP said:

“Several GP walk-in centres are seeing as few as four patients a day. It’s a far cry from the one million additional appointments promised by John Swinney.

He added:

“The Scottish government need to urgently rethink this plan and start listening to the voices of nurses and doctors.”

Scottish Labour’s Jackie Baillie MSP told parliament Scotland should simply “fund existing GP practices, which should be the walk-in clinics in everybody’s community”, rather than creating new centres.

Effective alternatives

In their statement, the RCGP Scotland, Royal College of Pharmacy (Scotland) and the Chartered Society of Physiotherapy (CSP) Scotland say investing in the following would deliver sustainable improvements in both access and patient experience:

• Modern IT and digital infrastructure;
• Improving information sharing between general practice and community pharmacy;
• Strengthening continuity of care – with benefits to patient satisfaction and reduced mortality;
• Enhancing GP telephony and appointment booking systems; and
• Taking action to address "missingness" across healthcare services.

Commenting, RCGP Scotland Chair Dr Chris Provan says GPs like him are as frustrated as patients when difficulties arise in getting an appointment:

“Patients should be able to see their trusted GP in a timely way, and GPs are committed to supporting efforts that improve access to care.

"That is why we are calling on the Scottish Government to focus on measures that we know will make a real difference. This includes investing in IT and digital infrastructure, supporting practices to improve telephony and appointment booking systems, and tackling the barriers that prevent some patients from accessing healthcare.

"These practical solutions would do far more to help patients see the right healthcare professional at the right time than piloting GP walk-in centres, which risk duplicating existing services at significant cost, worsening health inequalities, and repeating approaches that have failed to deliver elsewhere.

"Ultimately, the most effective way to improve timely access to general practice is to increase capacity within the system. That means training, recruiting and retaining more GPs, and growing the number of appointments available to patients."

Director for Scotland for the Royal College of Pharmacy, Laura Wilson says Scotland already has a network of walk-in healthcare hubs improving access for patients, particularly in areas of highest need:

“Community pharmacies across Scotland are based on local high streets and in other community spaces. These services have high footfall and already provide a wide range of walk-in services for typical conditions such as urinary tract infections, respiratory and chest infections, ear, nose, and throat issues, skin conditions, and eye infections.

"GP walk in centres duplicate this offering and have the potential to divert a significant amount of resources away from where they are needed most. From a health inequalities perspective, Community pharmacies buck the inverse care law because their distribution is heavily concentrated in high-deprivation neighbourhoods where health needs are greatest. 

“Instead of investing to duplicate resource, we would prefer to see investment directed into revolutionising the existing primary care offering; including by creating interoperable digital systems which allow for patient information to be shared with community pharmacy teams so that pharmacists have access to all the information required to be able to effectively treat patients in the community.”

Multi-professional GP teams

Last October, the Scottish government pledged an additional £250 million in funding for primary care services. Some of that is being invested in additional allied health professionals’ hours.

The CSP’s Professional Adviser for Scotland, Sara Conroy says building broad teams will help deliver the healthcare people want to see in their communities:

“Primary care improvement funding has seen investment in the wider multidisciplinary team, including over 250 advanced practice physiotherapists in GP practices.

"There remains a need to continue to invest in a multi-professional approach to services in primary and community settings, to see patients earlier in the pathway, and to ensure access to the right professional in the right place at the right time.

“There must be a whole-system approach to improving primary care, and workforce planning to provide the healthcare staff and resources needed.”

 

Read more: Briefing: NHS reform in the Holyrood manifestos; Community Link Workers reducing stress on GPs ; New NHS staff data makes case for workforce plan; RCGP: Future of general practice model at risk ; Half billion pound GP investment ‘largest ever’

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