Scottish GPs quitting rather than moving to life online

Older GPs are finding it hard to move to online consultation with patients and choosing to retire early from the profession as a result, the Royal College of General Practitioners in Scotland has revealed.

Holyrood’s Covid-19 Recovery Committee today asked the leaders of four doctors’ organsiations why so many healthcare professionals are quitting and recruitment to the NHS has been so challenging.

Earlier, the watchdog Audit Scotland, in its annual state of the NHS report, referred to government plans to recruit and retain staff as ‘ambitious and will be challenging to achieve given the NHS’s historical struggles to recruit enough people with the right skills’.

Today’s witnesses pointed to a root problem of doctors and other healthcare professionals feeling undervalued by the NHS, media, public and politicians.

The Joint Chair of the Royal College of General Practitioners in Scotland, Dr David Shackles, said family doctors faced particular challenges having been forced away from traditional face-to-face appointments.

He predicted that remote consultations – which became the main way that patients were seeing their GPs at the height of the pandemic – will settle back to about 35% of appointments. However, he told the MSPs that some of his colleagues were finding it difficult to adapt:

“Patients still value a face-to-face consultation, as do the doctors.

“It’s what gave us a lot of job satisfaction and that is one of the difficulties that we are seeing in retention, where older doctors in particular are not enjoying these ways of working – they’re not getting the same satisfaction from seeing their patients – and they’re saying, “You know what, if that’s what it’s going to be, we don’t want it”.”

This echoed comments made by Scottish Care’s Dr Donald Macaskill earlier this week, who told Holyrood’s health and care committee that home carers are being treated with a lack of ‘trust, respect and individual autonomy’, which was partly to blame for recruitment and retention issues:

“It took eight weeks before we started to clap, not just for the NHS but for carers. It took weeks before supermarkets started to recognise social care staff as being just as significant as NHS staff and give them priority,” he told that committee on Tuesday.

The doctors reminded the Covid-19 Recovery Committee today that growing and maintaining the clinical workforce is as much about retaining professionals as recruiting new ones.

Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, suggested it was wrong to see this as simply about the risk of older more established senior staff taking early retirement:

“As international travel opens up again, I worry that some of our trainees might start to say “I’m going to look elsewhere myself and go and work there”.

“And for many of them, it’s things like respect and value in the workplace and the messaging that they get in the media, and from politicians indeed, about how much they are respected and valued.”

Professor Elder said respect for staff is also about how their workplace:

“It’s about things like access to somewhere to rest when you’re on call. To hot food. We have had the story in the media recently about accessibility or otherwise of period products in Scottish hospitals.

“So, there are actually some basic things across all of our hospitals that we need to focus on more that make our trainees, I would suggest just as much the consultants, feel that they truly are valued so that they are more likely to remain part of our workforce.”

Scottish Intensive Care Society President, Dr Barbara Miles, agreed that there were short-term ways of improving staff wellbeing:

“It’s not difficult things. It is rest areas, better transport links, parking, hot food – to show the workforce that they are valued.”

While agreeing with his fellow witnesses on the need for practical support for frontline healthcare staff, the Vice President of the Royal College of Emergency Medicine in Scotland, Dr John Thomson, said one of the main things dragging down A&E teams is the frustration of there being no capacity across the whole hospital system – which they feel most acutely working at the emergency department ‘front door’:

“One of things that will improve the wellbeing of our colleagues is actually reducing the waits for patients in emergency departments by improving the system and improving the care that we are delivering to patients.

“That is the main point that would improve our wellbeing. Not financial remuneration. Not improved terms and conditions, but actually seeing that the care we are delivering is improving for our patients.”

The Covid-19 Recovery Committee is holding an inquiry into excess deaths during the pandemic after government figures showed deaths in Scotland are 11% above the average. It is seeking evidence on the impact of reduced NHS services, increased waiting times and the apparent trend towards people waiting longer to seek medical help and presenting with more advanced illness as a result.

The committee has raised concern about the lack of health data that might explain the so-called excess deaths.

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