General practice in Scotland is at a "tipping point" and in "serious trouble", the leader of Scotland's GPs will warn today.

Family doctors gathering on the outskirts of Glasgow for their annual conference are set to discuss a range of issues facing the profession, including "chronic underfunding" and the threat of "financial ruin" facing practices as a result of spiralling utility bills and increased interest rates on mortgages.

Concerns are also being raised over the growing numbers of patients seeking follow up care from GPs following private treatment abroad, with the conference agenda noting that patients "aren’t aware of the fact they are not entitled to NHS follow up when returning" and that GPs are being expected to "perform specialist follow up which is outwith their competence".

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Dr Andrew Buist, chair of the BMA’s Scottish GP Committee, will deliver his sixth and final address today at the Scottish Local Medical Committee (SLMC) conference in Clydebank.

He will warn that GP practices are "running on empty" in many parts of Scotland, with GPs "exhausted and burnt out".

Members surveyed ahead of the meeting said that their biggest gripes were lack of priority given to investment in general practice compared to secondary care, the "unwarranted criticism" of GPs when patients struggle to get appointments, and "unmanageable workload".

Dr Buist will tell the conference that there are too few GPs to meet the needs of the Scottish population, saying that many GPs are "working beyond the limit of what is safe".

The BMA has recommended a limit of 25 consultations per day per GP, but a motion from doctors in Grampian said that practices had "struggled to implement this due to the potential harm to patients and the risk of increasing complaints".

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A growing number of surgeries in Scotland are being taken over by health boards as GP partners retire or quit in favour of working as salaried or locum GPs, while the size of the workforce - counted as full-time GPs - has also shrunk.

This has coincided with growing demand from patients with health problems exacerbated by the pandemic, waiting list delays, and the cost of living crisis.

Dr Buist adds: “It is worth noting that in the last 10 years the Scottish population has increased by 7% - while the number of practices has reduced by 9% and average list sizes have increased by 18%.

"Workload pressures mean it is becoming increasingly unattractive to be a GP partner – and the model of general practice as patients have previously come to know, based on continuity of care and access to a GP who knows them, is threatened.

“We have reached a tipping point in general practice and I believe we are in serious trouble.

"The independent contractor GP model has served us well for over 70 years and, if properly funded, could serve Scotland for many more decades – but core general practice desperately requires more funding to meet the population needs, and is the key action to take pressure off secondary care services.

"But without it, we simply cannot give the people of Scotland the level of care they need and deserve."

Dr Buist will call on the Scottish Government to "come good on its commitment to having a national conversation on the future of Scotland’s NHS" and what the public want from it.

The Herald: The number of GP, by whole-time equivalent, has fallen from 3,675 to 3,494The number of GP, by whole-time equivalent, has fallen from 3,675 to 3,494 (Image: PHS)The Herald: The number of GPs who are partners ('performers') - the doctors liable for running practices - is steadily falling, making practices increasingly vulnerable to collapseThe number of GPs who are partners ('performers') - the doctors liable for running practices - is steadily falling, making practices increasingly vulnerable to collapse (Image: PHS)

It follows comments earlier this week from former NHS Scotland chief executive, Professor Paul Gray, who said a "mature conversation" was needed on issues such as greater use of the private sector or charging some patients for treatment - something Health Secretary Michael Matheson has ruled out.

The Scottish Government stresses that Scotland has more GPs per head than any other UK nation, and is "making good progress" on its commitment to recruit at least 800 new GPs by 2027.

A spokesman added: "Since 2017, Scotland’s GP headcount has increased by 291 to a record high of 5,209 in 2022.

“To support general practice we currently have 4,731 staff working in Multi-Disciplinary Teams providing services including physiotherapy, pharmacy and phlebotomy, giving an average practice access to more than five additional multidisciplinary team members."