A brutal report from Audit Scotland finds that the number of GPs in Scotland has fallen since 2018 as healthcare spending slumps 6%. 

A Scottish Government agreement with GPs to improve general practice has failed to deliver on several of its commitments which means that healthcare services may be cut. 

The 2018 General Medical Service (GMS) contract aimed to address the financial pressures and growing workloads facing GPs, and to improve patients’ access to care.

Instead, says Audit Scotland, the effect seven years on is that the estimated number of whole-time equivalent GPs has fallen, the pressure on general practice has increased and proposals to support GP teams with more nurses, physiotherapists and other specialists have moved more slowly than planned. 

This means, concludes the report General practice: Progress since the 2018 General Medical Services contract is that people are finding it more difficult to access care.

Affected by the pandemic

“The pandemic pushed back plans for general practice. But the new delivery deadlines that were put in place were missed, and there’s not been enough transparency about progress since then,” said Stephen Boyle, auditor general for Scotland. 

The Scottish government has not set out how it intends to invest in general practice over the medium-term, the report says. It concludes that it is unlikely to hit its target of 800 more GPs by 2027 as spending on general practice as a proportion of overall NHS spending has fallen in recent years. 

Any aims have not been helped that since 2021, spending has decreased by 6% in real terms, which has put more pressure on GP practices.

On top of a lack of funding, national data for primary care, the auditor general says, remains inadequate. There is a lack of robust information about general practice demand, workload, workforce, and quality of care. 

“The Scottish government needs to clarify its plan for general practice and set out the actions, timescales and costs to deliver it,” said Boyle. 

In response to the report, Iain Morrison, chair of BMA Scottish general practitioners committee, said: “This Audit Scotland report demonstrates in forensic detail exactly why so many practices across Scotland are struggling to meet demand and the enormous pressures so many GPs are having to work under which has left them angry and demoralised.”