Waiting for news about the #gpcontract rural SLWG

Members of the Rural GP Association of Scotland (RGPAS) are waiting patiently for news about the rural Short Life Working Group – the much-promised mechanism by which the Scottish Government has sought to reassure that implementation of the new GP contract to rural communities will be overseen.

RGPAS wrote to Cabinet Secretary for Health, Shona Robison MSP on 14th March, and yet to date we have had no response other than to confirm that our letter is ‘being considered’.  No formal announcement has been made as yet, despite early reassurances being offered that the SLWG would address concerns raised by rural GPs prior to the contract’s agreement.

What do Scotland’s rural GPs think?

Today we will be publishing the results of our latest members’ survey, which continues to demonstrate concern, disappointment and anxiety about how the new contract threatens to make rural practice in Scotland unsustainable.

  • Nearly 70% of respondents say they are less confident that the contract changes will be beneficial to Scottish rural practices
  • Nearly 70% of respondents say they are less confident about their rural practice’s sustainability due to the new contract
  • 97% of respondents believe that RGPAS should be represented on the rural Short Life Working Group
  • 97% of respondents have been happy with the RGPAS efforts to raise our members’ concerns about the new contract

What has been said so far about the SLWG?

On 25th January 2018, First Minister Nicola Sturgeon apparently advised that the SLWG had been set up.

Of course we must listen to the issues for rural GPs, which is why a short-life working group has been established to look specifically at those issues. Members do not simply have to listen to the Scottish Government on this; it is the British Medical Association’s position that the concerns that are being expressed by rural GPs are unfounded and that no GP will lose funding as a result of the new contract. That is the reality of the situation, but I accept that we have to convince rural GPs that that is the case, and we will continue to work collaboratively with them to seek to do exactly that.

First Minister for Scotland, Nicola Sturgeon, speaking at First Minister’s Questions on 25.1.18

(Quote from theyworkforyou.com website)

You can watch the above announcement being made in the video clip below.

Since then we have heard very little, and we remain in the dark about how the SLWG will function, how it will represent rural GPs in Scotland and how key stakeholders like RGPAS and LMCs will be able to contribute to this forum.

RGPAS call for action from the Scottish Government

We call on the Scottish Government to understand the level of concern expressed, and to respond to it in a transparent, co-operative and effective manner.   RGPAS is ready to contribute constructively to the rural SLWG.  Inclusion in the Short Life Working Group should be forthcoming for both RGPAS and relevant LMC representatives, including Highland LMC which we suspect represents the majority of Scotland’s rural GPs.

Inevitably, the schedules of Scotland’s rural GPs are busy and require advance planning, and therefore we request adequate notice and arrangements to ensure effective representation.  We also hope to see adequate patient representation given that the new contract paves the way to redesigning primary care services for all of Scotland’s communities.

The issues facing rural Scottish General Practice are complex, this has been acknowledged by SG and SGPC. Phase one of the new GP contract did not adequately address these issues.  We believe that the solutions can be found to deliver a fit for purpose, rural-proofed contract. The answers lie in the rural workforce and as such we are very keen to represent remote and rural GPs on the SLWG.

Dr Alida MacGregor (GP Principal, Cowal Peninsula), RGPAS Vice-Chair

We would like clarification regarding the timing and make-up of the ‘Short Life Working Group’.  As representatives of many rural GPs in Scotland who will be affected by the contract, we believe that it is essential to  have the opportunity to represent our members’ views . We are ready to contribute to this important opportunity to develop local primary care services – particularly as GPs are often in the best position of understanding the needs of their communities and the ways in which services can be most effectively delivered.

Dr Susan Bowie (GP Principal, Shetland), RGPAS Secretary

It has been widely acknowledged that the 2018 GP contract almost completely ignored the potential opportunities for developing rural general practice and also failed to address the problems facing us.  I welcome the setting up of a SLWG to address these deficiencies and see it as an opportunity for SGPC to regain some credibility with rural doctors. In order to do so it is essential that grass roots remote and rural doctors are strongly represented on the group. In my opinion this would best be done by including Highland LMC and the Rural GP Association of Scotland. Failure to do so will miss an opportunity to strengthen rural practice, and further reinforce the perception that rural medicine is undervalued by the centre.

Dr Richard Weekes (GP Principal, Ullapool), RGPAS Committee Additional Member

The new contract for Scottish GPs received virtually no support among rural doctors, and Scottish Government sought to reassure them by announcing a Rural Short Life Working Group. It is vital to ensure that the two organisations representing the majority of rural GPs – RGPAS and Highland LMC – will be included in the working group. Rural GPs across Scotland, particularly the majority who fear that the contract will make their practices unsustainable, will see effective representation of their concerns as being a vital to implement the new contract successfully.

Prof Phil Wilson (GP Inverness & Director of the Centre for Rural Health), RGPAS Research Lead

RGPAS have consistently put forward constructive ideas to solve the serious lack of an effective rural element in new contract.  RGPAS and the Highland LMC are able to offer considerable insight, expertise and credible representation on rural issues to the Short Life Working Group.   The new contract can still be rural-proofed, but only if those with a deep practical knowledge of rural health are at the heart of the SLWG.

Dr Douglas Deans, RGPAS Committee Co-opted Member (Rural Faculty)

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