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What could reduce GP workload and improve healthcare access?

While GP caseloads continue to grow across Scotland, a number of initiatives spearheaded by health boards, surgeries and charities have sought to try and find solutions. Could doing more of this work? The Ferret looked at the evidence for three different approaches.

GPs Crisis medical

Wellbeing Hubs 

In West Lothian, NHS Community Wellbeing Hubs have been set up in Livingston and Bathgate to provide multi-disciplinary support and resources to people with mental health difficulties such as stress, depression and anxiety. 

NHS therapists work alongside community link workers from local charity Lanarkshire Association for Mental Health (LAMH) to provide holistic and tailored support ranging from therapy to self-help and clinical interventions. In their first six months of operation (June to November 2019) the hubs supported 836 people, although the direct impact on GP caseloads is unclear. Those accessing them are still required to be signposted by a GP in the first instance. Updated data is not available. 

A 2020 Scottish Government report set out principles for the delivery of mental health services in primary care and the community, with funding made available for these services. A number of similar hubs are currently in development including in areas of Glasgow identified as particularly deprived, such as Govanhill and Springburn, but no date has yet been announced on when they might open. 

Charity projects

The Ripple is a charity, based in the east of Edinburgh, which works to tackle poverty and inequality within the local community. Alongside the Edinburgh Health and Social Care Partnership, The Ripple has established a Catch Your Breath group for those with long-term lung conditions as well as offering regular exercise classes for all abilities. 

Last October it launched a weekly outdoor swimming group which it says is aimed at promoting wellbeing and helping people feel good in a way that’s “free, accessible and local” with a low impact on the planet. The group meets at Portobello beach to swim, but aims to go further afield in the warmer months. Once a month the charity invites a doctor from the local GP practice to come too, aiming at helping the group to build trusted relationships with a doctor. 

What could reduce GP workload and improve healthcare access? 2
Catch Your Breath meets at Portobello beach to swim. Image: Nikos Niotis/Flickr

Meanwhile Chest, Heart and Stroke Scotland’s health defence team provide a range of services from free health checks to physical activity sessions, both in person and online. The charity has opened two “health defence hubs” in Glasgow’s Drumchapel and Maryhill neighbourhoods, which can be accessed on a drop-in basis or via an appointment booked online. 

Anyone attending will have their blood pressure, weight and cholesterol levels checked and support and advice on healthy living will be offered. Activity sessions from chair-based activity to circuits and healthy walks are also on offer. Those outwith Glasgow can request a phone or zoom call to discuss their physical health and mental wellbeing.

Out-of-hours solutions 

Some GP surgeries themselves have tried to tackle the problem of increasing caseloads, including by extending their opening hours. Earlier this year, NHS Lanarkshire announced that a number of its surgeries would open on Saturdays throughout January, when demand is usually high. 

However, weekend opening was previously included in the 2015 Conservative Party’s Westminster manifesto and met with mixed response. A 2015 study from the universities of Oxford and East Anglia found that weekend opening was unlikely to be enough to meet patient needs, with lead researcher Dr John Ford explaining that a “key problem is that many practices do not currently have capacity to provide weekend opening in addition to weekday services. 

“This means that a reduction in weekday services would be necessary – which could actually reduce access for patients who find it easier to see their GP during the traditional working week,”  he said. 

Cover image thanks to Karolina Grabowska/Pexels

GPs in Crisis is an investigation by The Ferret examining the pressure on doctors and patients at the frontline of community healthcare. Support our journalism by becoming a member for £5 a month at theferret.scot/subscribe.

This story is part of our Health Gap project, funded by the European Journalism Centre, through the Solutions Journalism Accelerator. The fund is supported by the Bill & Melinda Gates Foundation.

2 comments
  1. Multi disciplinary teams are a brilliant idea but interesting coastal area of Moray there is no direct bus link. The journey by public transport takes anything up to four hours. 20 minite neighbourhood? I think not.SOS is a campaign group set up to cover the communities of Burghead , Cummingston, Hopeman,Roseisle and Duffus. The GP Surgeries were closed due to lockdown. The local integrated joint board proposed a consultation. The outcome was 85% of those consulted did not want their surgeries to close. However MIJB continued to insist on closure. It has taken months to persuade anyone to talk to us, so we resorted to using press contacts who carried our story. Our elected members came on board. Recently our campaign has been brought to the attention of members in Westminster and Holyrood. Cabinet Secretary for Health had agreed to meet us and we intend presenting our petition to Holyrood where the First Minister has agreed to meet us. We don’t know what the out ome will be but the ripples from the ‘minnows’in Moray have spread.

  2. Applauding CHSS instead of investigating them is bewildering. They’ve received millions in funding for Long Covid, but essentially squandered it on resources that everyone agrees are pretty much redundant. Despite having their own Long COVID clinician, and being aware of the latest research – repeat infection and exposure results in increased risk of LC and complications, it’s an airborne virus etc – they’ve continued to organise events for the vulnerable people they claim to represent without addressing mitigation measures. Elsewhere they had over 4 MILLION in stocks (unspent money that could be better used) and their director wages jumped to £90’000+. Most people in the Long Covid community avoid interaction with them due to their reluctance to fund and promote research, and the way they capitalised on a crisis. They also used the Long Covid hearings to position themselves as an expert on the condition (ridiculous) but ultimately to try and leverage greater access to the NHS database and secure themselves as a third sector NHS affiliated organisation.
    Crisis Capitalists.

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