THE number of GP partners working in Scotland is at a record low as increasing numbers of family doctors are abandoning the responsibilities of running practices.

The latest workforce statistics show that more GPs than ever before are being paid a salary instead of earning their income as an independent contractor, in a sign of the strain facing the profession.

In the space of just 15 years, between 2004 and 2019, the percentage of GPs in Scotland who are salaried has soared from 4 per cent to 21%.

They now account for 1,064 of the workforce, up from 188 in 2004.

Over the same period, the proportion who are GP partners has shrunk from 85% to 66%, from 3,782 out of a total GP headcount of 4,456 in 2004 to 3,336 out of 5,049 in 2019.

Since the founding of the NHS in 1948, general practice has been built on a partnership model that sees doctors run their own surgeries like small businesses.

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Although that came with a freedom to set their own incomes, opening hours and additional patient services, the pressures of owning and maintaining the premises, employing staff, and covering overheads such as heating and electricity has spurred a growing number of experienced GPs to pull out of partnerships in favour of becoming salaried instead.

Many younger GPs starting out on their careers are reluctant to take on the burden at all.

The trend has led to practices folding, merging with other surgeries or being taken over by health boards.

The number of GP practices in Scotland has fallen by 9%, from 1,023 in 2009 to 935 in 2019.

Dr Andrew Buist, chair of BMA Scotland’s GP committee, said: “GP headcount has remained relatively stable in Scotland over the years, however this comes against a backdrop of fewer partners and more GPs increasingly working part-time, while demand for care has increased dramatically.

"On this basis we desperately need more GPs, and more GPs to become partners.

"It is also why the Scottish Government’s commitment to have an extra 800 GPs in Scotland by 2027 must reflect the full picture – including the increase in less than full-time GPs.

"We need a credible plan on how this extra recruitment will be delivered and we need that urgently."

Although the statistics, from ISD Scotland, show that GP numbers by headcount have exceeded 5000 for the first time this year - up 55 from 2018 - the data does not take into account a rise in part-time working.

The number of female GPs overtook males for the first time in 2009 and has continued to climb, with nearly two-thirds of GPs in Scotland now women.

However, female GPs are much more likely than their male counterparts to work part-time.

Older GPs nearing retirement are also likely to reduce their hours and one in three GPs in Scotland is aged 50 or older.

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The last statistics which counted the GP workforce on a full-time equivalent basis - a more accurate reflection of real-terms staffing - found that it had declined from 3,735 in 2013 to 3,575 by 2017. The next dataset is due in 2020.

Dr Alasdair Forbes, deputy chair of the Royal College of GPs Scotland, said: “While today’s figures show a small increase in the total number of GPs working in Scotland, this does not reflect the reality on the ground.

"These figures capture only the total number of GPs working in Scotland and they do not take into account the number of sessions that GPs are currently working in general practice.

"We have consistently called for GP workforce numbers to be collected in whole-time equivalent rather than headcount numbers to allow for more accurate workforce planning."

The Scottish Government has argued that the new GP contract, introduced last year, will strengthen general practice by providing financial support towards premises' costs and creating an expanded practice team of pharmacists, physiotherapists and other healthcare professionals to ease the workload on GPs.

Health Secretary Jeane Freeman said: “There are more GPs per head in Scotland than the rest of the UK and this year we’ve seen the highest number of GP Speciality Training posts filled since 2015.

“By the end of this Parliament we’ll be investing an additional £500 million per year into primary care, including £250m in direct support of general practice. We are also making 105 more places available by 2022 for new graduates on the Foundation Training Programme.

“The first 51 training posts will be available in 2021 for students to continue their training to become qualified doctors and we are prioritising structural reforms in postgraduate support of general practice by 2021.”

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Meanwhile, concerns have been raised over a 21% year-on-year increase consultant vacancies for NHS Scotland, with 475 posts - or eight in every 100 - unfilled as of September this year.

Of those, 250 had been empty for at least six months, including 48 psychiatric posts, 33 in clinical radiology and 49 for surgery.

The BMA warned that the shortfall is probably even higher as posts which are vacant, but not advertised, are not counted.

Alan Robertson, deputy chair of the BMA’s Scottish Consultants Committee said: “The substantial long-term gaps in Scotland’s workforce are a growing and serious concern – stretching the workforce to the limit and affecting the ability of doctors to deliver the high-quality patient care they strive for.

"The Government needs to take urgent and long-lasting action to address this deeply worrying lack of doctors.”

The Royal College of Emergency Medicine (RCEM) also warned that its members are increasingly concerned that Scotland is facing its "worst winter for long trolley waits and corridor care".

It comes as figures show that 1,179 patients spent more than 12 hours in A&E during October and November this year - a four-fold increase compared to 290 for the same period in 2018.

Dr David Chung, vice president of RCEM Scotland said: “Whilst there is increased demand in people attending emergency departments, these long waits are almost all patients waiting for a bed to be admitted to in the hospital. In some cases, this is taking over 24 hrs.

"This is not an acceptable way to provide care in the 21st century and is undoubtedly taking its toll on patients and staff.

“The fact that many health boards are running out of beds every day, obviously means that there are not enough beds in the system, there is not enough care capacity in the community, or both.”

Ms Freeman said Scotland had "substantially more staff per head than the health service in England", and that overall staffing had risen by 11.3% under the SNP to a record high.