GP crisis sees overnight out-of-hours suspended at all four NHS Greater Glasgow and Clyde sites

Camley's Cartoon: Row over GP night cover.

However, a spokeswoman confirmed that a lack of GPs forced them to cancel the service overnight at all four sites from January 8 into January 9.

She stressed that a home visiting service which prioritises patients who are terminally ill or housebound remained in place, and that all patients who were triaged as needing a GP at home had been seen.

There was further disruption on January 9 when there were only enough staff to run GP OOH at the RAH in Paisley.

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Evening OOH should also be available at the Queen Elizabeth University Hospital, Gartnavel Hospital, Easterhouse and Greenock health centres from 6pm, but was cancelled on January 8 due to staff shortages.

The GP-led Minor Injuries Unit at the Vale of Leven hospital in West Dunbartonshire - which is the only MIU in the region which operates 24 hours all-year-round - remained open both nights, however.  

It comes days after Health Secretary Jeane Freeman told the Herald that improving NHS GGC's out of hours GP service was among her priorities, saying it "needs significant improvement".

The Scottish Government intervened in June last year when it emerged that all but one of the five OOH units then operational had been forced to close over a weekend due to GP shortages.

Six months on, an NHS source told the Herald that the OOH departments were still "in crisis".

They said: "Morale is at rock bottom and patients are coming to harm."

A second NHS source said blanket closures are becoming increasingly common, and that on occasions there has been only one GP available for home visits across the whole of Glasgow when the service is supposed to have four to serve east, west, north and south.

They said: "This is happening more frequently and the closures are not made public in advance.

"Often now barely half of the centres are open in the evening and we are experiencing more overnight closures of the facilities. There have been occasions where there was only one GP on shift for home visits in Glasgow.

"Inverclyde is often hardest hit, with patients having to travel into Glasgow.

"Basically the health board are not fulfilling their obligation to ensure fair and reasonable access to health care."

The health board admitted last year that it was struggling to provide OOH cover due to "a lack of GPs willing to work the shifts".

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The issue has escalated after the new Scottish GP contract, introduced in April 2018, removed a financial penalty for GP who opted out of OOH, but the problem appears to be far more acute in Greater Glasgow and Clyde than in other health board areas.

It is understood that NHS GGC is trying to recruit around 70 GPs to plug the shortfall.

Another anomaly is that NHS GGC is the only health board in Scotland which operates GP OOH as a walk-in service rather than appointments-based, making it more prone to queues.

A spokeswoman said they are "working towards" an appointments-based system and urged anyone feeling unwell to contact NHS 24 first so that they can be directed to their nearest available and most appropriate service - OOH, a minor injuries unit, or A&E.

Scottish Labour's health spokeswoman Monica Lennon MSP said: “Pressures on out of hours services continues to put additional pressure on A&E, which results in patients waiting hours to be seen.

“It’s extremely concerning and means that those who most need help are being let down."

Scottish Conservative health spokesman Miles Briggs said the latest developments were "deeply concerning".

He added: “The NHS workforce crisis we are seeing is a direct result of a lost decade to improve our under the SNP and the total mismanagement of our Scottish NHS.”

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A spokeswoman for NHS GGC said: "We are fully committed to ensuring that every patient across NHS GGC) who requires GP OOH care will get it.

"Our GPs provide a valuable service for patients who are unwell, both in and out of hours, but it must be stressed that the GP OOH service is for urgent GP attendances who cannot wait until their practice opens during normal hours.

"We have recently launched a campaign emphasising the need for patients to phone NHS 24 for an appointment with the GP OOH service and not just walk in as this causes unnecessary delays for other patients.

"We have already seen a drop in the number of patients walking into our GP OOH services and with a number of further developments underway in primary and community services, patients will be offered a wider range of choice in terms of getting the support they need out of hours quicker.

"In addition, there are a number of further improvements being actioned with immediate effect including:

- working with the GPs to identify and make improvements to the Out of Hours facilities for both GPs and patients;

- reviewing the patient attendances to manage and reduce further walk-ins and introduce patient appointments;

- bolstering the multi-disciplinary teams with additional staffing."