By Andy Drane

BREXIT aside, commentators will also be watching closely whether the Conservative Government will deliver on its health service pledges, including the promise to recruit an extra 6,000 GPs in England and Wales. Attention will also focus north of the Border where health policy is a devolved matter. As both Westminster and Holyrood ministers know, GP recruitment is no simple task and one that’s further complicated by the attempted integration of health and social care, a current focus for the Scottish Government.

While governments have been grappling with this challenge for years, it’s now having a significant impact on primary care and needs sorting as a matter of urgency.

Training more doctors takes years: those who start a medicine degree in 2020 will not be fully fledged partner level GPs until 2030 at the earliest. Meanwhile, recruiting experienced doctors from abroad can be a costly and lengthy process.

There are, however, practical measures which both Scottish and UK Governments can and must deliver which can make an immediate difference. The first is to get on with implementing current policy. In Scotland this involves delivering the key support policies announced in the 2018 New GP Contract, including providing sustainability loans to support GP practices. The Scottish Government must ensure that all health boards take a consistent approach in implementing this legislation.

The UK Conservative Government should address the issues which prevent older, experienced GPs from working. This includes fixing the pensions crisis where currently all GP earnings are superannuable at fixed percentages. This means retired doctors risk breaching annual or, in some cases, lifetime allowance limits and face punitive tax levels for taking on additional work.

Retaining middle-aged doctors by encouraging those with younger families, who’ve reduced hours or taken time out, to return to general practice once childcare commitments change is another key policy challenge.

Both governments should also look at innovative ways of incentivising more student doctors into a career within general practice. Innovative policies, including requiring UK-trained doctors to remain working here for a minimum period, are also needed to prevent an exodus of qualified GPs to other nations.

To increase the effectiveness of GPs, we also need to see more imaginative government policies aimed at relieving the administrative burden they face. One route is to encourage the development of larger practices which are of sufficient scale to be able to provide for a proper separation of clinical care delivery from management of the business. This could be supported by regulatory requirements to have appropriately qualified practice managers in place at all GP surgeries. Where larger practices are not achievable, it will be essential to encourage smaller ones to come together to share business management resources.

Training on more efficient healthcare delivery is another area of consideration. This could include limiting the number of weekly visits by “frequent flyer” patients but balancing this by offering them longer consultation times to deal with their issues.

A final aspect of the GP challenge for governments is around investing in public health campaigns to route patients to nurses or other health professionals to ensure GP time is available when it is actually required.

Fixing primary care will be hugely challenging for both the UK and Scottish Governments. While these measures outlined above won’t be enough to achieve it, they will at least help address some of the longer term retention issues.

We’ve heard much talk from all politicians on this matter – it’s now time for action. Our nation’s health depends on it.

Andy Drane is partner and GP practice adviser with law firm Davidson Chalmers Stewart