NATIONAL PRIMARY CARE WORKFORCE SURVEY ADVISORY GROUP REPORT ON 2013 SURVEY - WEB ONLY

Other Issues For Consideration

60. The Group's remit included making recommendations in respect of other work which could be undertaken to examine in more detail the changing nature of the primary care workforce in Scotland. The following summary of feedback received falls outwith the potential scope of the Survey and any future Advisory Groups established to develop and plan future exercises. However, the Group considered there would be value in the Scottish Government exploring these issues further with relevant stakeholders.

• The distribution of doctor and nurse sessions/resource across and within Boards; significant variation is noted in the survey results and it is not known how well this variation in session/resources is matched to local demand/need.
• The possible tension between continuity and GP availability; as more GPs, for whatever reason, work less than full time (however that is defined) how is continuity, which is known to be important for some groups e.g. elderly with long term conditions, reconciled with less than full time working in practice (portfolio careers are more common now, including capacity for crucial GP leadership roles e.g. in the integration agenda).
• Skill mix and the implications for working within and across GP teams and other service providers/professions; successive surveys have shown a slight trend towards a greater role for non-medical staffing of the primary care team e.g. nurse practitioners, practice nurses, health care assistants, phlebotomists. Given the changing demographics and increasing complexity (multi-morbidity) is the general practice workforce maximally configured for current and future demands/needs?
• The value of highlighting the Survey's existence during Practice Manager induction/training, so that Practice Managers know to expect it and are aware of the importance of submitting a well completed return.
• The opportunity to review/consider a salaried contract option for everyone/significant elements of the GP workforce, particularly in OOH.
• The need to review what appear to be relatively flat payment scales OOH, i.e. a circumstance with no increments based on experience may not be incentivising more experienced GPs to work in OOH settings.
• In considering moves to an even more Scottish contract, should Scotland seek to gather the evidence that would be required to help inform future pay awards, and at the same time increase its understanding of the challenges facing the profession in Scotland; flagging up the issues that may need to be considered in the context of pay - e.g. the age and sex of the workforce, the motivation of GPs in light of pay awards (at the moment there are only media or anecdotal reports on which to base this), GP workload (such as time spent on bureaucracy as opposed to patient care) or the impact of any changes to the NHS (such as the integration of health and social care) on attitudes to GP workload.