GP Retention Working Group: report and recommendations

4. Existing Activity that supports GP Retention

Members of the working group identified a number of pieces of work that were integral to the overall approach needed to retain GPs. This section sets out these pieces of work, alongside the progress to date in implementation.

4.1 Workforce Data

The annual workforce survey data is collected each year from practices by NHS National Services Scotland (NSS), and the data is then analysed by NES for publication.

The Scottish Government is currently working with NSS to identify a system which will enable real-time reporting of workforce data. It is expected that this will improve the level of reporting and accuracy of data, and consequently provide a better understanding of pressures in the system.

Workforce data collected through the survey can only be estimated based on the returns that are received from practices. This includes data on the Whole Time Equivalent (WTE) number of GPs, which should provide a clear indication of the capacity within the system. In 2023 NSS achieved a return rate of 82%, but this will need to continue to improve to provide robust data on these metrics.

The Scottish Government currently measures progress against the commitment to increase the number of GPs using headcount data, as this provides an accurate number of GPs registered on the performers list in Scotland.

Both sets of data (GP Headcount and WTE) are essential to increasing GP capacity overall.

The Scottish Government is working with RCGP, SGPC and other stakeholders to improve the accuracy of reporting on WTE data, and finding a long-term solution to collecting GP workforce data.

4.2 Primary and Secondary Care Interface

The Scottish Government is working collaboratively with RCGP, Centre for Sustainable Delivery (CfSD), Health Board Interface Groups and with other relevant stakeholders to identify opportunities for new ways of working that can be applied nationally to challenges across the interface.

Support is offered through RCGP to Health Boards to develop dedicated Primary and Secondary Care Interface Groups. Effective interface between primary and secondary will address the unplanned transfer of work between secondary and primary care.

4.3 National Conversation

The Mandate Letter from the First Minister to the Cabinet Secretary for Recovery, Health and Social Care made clear the commitment to “Set out a common approach for the reform of the NHS to improve population health and system sustainability to meet the needs of our diverse population of Scotland”. The Care and Wellbeing Portfolio will be a key vehicle to deliver this ambition.

The Scottish Government is scoping further reform work under the portfolio on long-term planning, to improve population health and create a more sustainable health and social care system. Primary and community health will be a core part of this.

4.4 General Practice IT Reprovision

The rollout of the new National General Practice IT system is being delivered by the national ‘GP IT’ re-provisioning programme, and is now fully underway with the first 4 NHS Health Boards (NHS Tayside, Lanarkshire, Lothian, and Grampian).

To date there are 123 GP practices currently live with the new system, with Tayside having now completed all their Vision-to-Vision migrations. We expect all Health Boards to enter into agreements with the Supplier by the end of the Framework on 31 January, and full rollout to be completed by mid-2026. This will help reduce the administration burden on GPs in the long term. Further work is needed to identify how IT and AI can reduce GP workload.

4.5 International Medical Graduates (IMGs)

International Medical Graduates make up a significant proportion of Scotland’s GP Training cohorts. It is essential that IMGs are retained in Scotland on completion of GPST training. The Scottish Government has developed and published guidance for GP practices to support them to become visa sponsors for IMGs after completing their GP Training. Due to current Home Office regulations, IMGs have four months to find employment as a GP on the completion of their training, with a practice that holds the relevant sponsor licence.

It is clear from the discussions at the working group that more needs to be done to support IMGs. This includes practical support in key aspects of their lives including visa applications, setting up bank accounts, and other key activities which support them to settle and build their lives in Scotland. This might be delivered through peer support approaches, and the availability of further information and support guides. Consideration should also be given to the further needs of IMGs as they look to establish their career in Scotland.

4.6 Existing GP Retention Initiatives

The Scottish Government currently fund several initiatives through NES and RCGP that are aimed at improving the education and training needs of GPs throughout their career, as well as supporting GPs to return and remain in General Practice. These include:

• Staying in Practice Scheme (SIPS): SIPS is a three-year programme, of two to six sessions per week, to offer GPs who were thinking of leaving the profession early due to burnout an opportunity to reduce their workload in a supportive practice. This is provided by NES
• GP Enhanced Induction and GP Returner Schemes: Supporting GPs who have been working out of the country to safely return to General Practice in Scotland and supporting overseas GPs with a route into General Practice, through enhanced induction based on their learning needs. This is provided by NES.
• GP Coaching: Providing coaching to GPS that are experiencing burn out and thinking of leaving the profession, to enable them to remain in General Practice. This is provided by NES.
• GP Retainer Scheme: The retainer Scheme is a time limited scheme to support qualified GPs on the Performer’s list who have caring responsibilities (usually for young children) which prevent them from committing to a more substantive post in General Practice. This is provided by NES.
• Golden Hellos: Golden Hellos offer a one-off payment of £10,000 to GPs taking up eligible posts in hard-to-fill locations across Scotland. This is provided by NES.
• Support for First 5s: providing newly qualified GPs with training to help them adapt to life as a GP. This is provided by NES.

4.7 Protected Learning Time (PLT)

The Scottish Government has issued guidance on the principles of providing PLT including consideration of the expanded MDT.