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Aberdeen GP crisis: Doctors explain why it’s happened – and what they say will fix it

A dozen GP practices in Aberdeen have stopped taking new sign-ups, and doctors are often seeing more than four times the recommended limit of patients. Here’s why.

Dr Mishaim Bhana says Aberdeen GPs are having to close their waiting lists for the safety of patients. Image: Kami Thomson/DC Thomson
Dr Mishaim Bhana says Aberdeen GPs are having to close their waiting lists for the safety of patients. Image: Kami Thomson/DC Thomson

Doctors fear new Aberdeen residents could have to travel as far as Moray to see their GP, with a record number of city surgeries now “full”.

Local medics are raising concern about the sheer volume of patients being seen – sometimes upwards of four times the recommended safe limit.

They’re hitting out that the laws protecting people from at-capacity nightclubs are more robust than similar rules in the healthcare sector.

And they’re concerned about practices being told to extend their opening hours for no  extra money – all while being threatened with penalties for not doing so.

Without urgent action they fear general practice will become “an extinct profession”.

Aberdeen GPs overloaded and practice lists ‘full’

Currently 12 Aberdeen practices have a closed patient list – covering “a substantial postcode area”.

It’s thought only two or three are still taking new registrations, with concerns they too will soon have to stop.

Doctors heading up the Grampian Local Medical Committee (LMC), which represents GPs across the region, says patients would be at risk if these clinics continued adding to their books.

City medics Mishaim Bhana and Samantha Fenwick – the group’s chair and medical director, respectively – have likened it to safe capacity levels and “one in, one out” policies at clubs and bars.

“Absurdly, the laws that safeguard party-goers and deter nightclubs from operating outwith their pre-determined safe levels of occupancy do not exist for general practice,” they said.

People waiting to enter an Aberdeen nightclub. GPs want to be able to close their lists in the same way.
‘One in, one out’ rules – like at this Aberdeen nightclub – don’t exist for GPs. Image: Jim Irvine/ DC Thomson

Instead, they claim any efforts to close patient lists often result in extra scrutiny and “significant financial penalties”.

As it stands, large numbers are feeling overworked with demand far outstripping supply.

The British Medical Association recommends GPs have no more than 25 patient contacts a day.

But the Grampian LMC says it’s “common” for doctors in the north-east to see more than double this.

And, on a busy Monday, “many” will deal with well over 100.

‘Aberdeen patients could have to travel to Moray’

This bottleneck means patients new to Aberdeen can’t always register with a GP practice close to them.

In these situations, they might have to be assigned somewhere further afield.

“We are potentially looking at a situation arising in the near future, where patients living in Aberdeen are having to travel to Aberdeenshire or, in extreme cases, even to Moray or further afield to see a doctor,” the LMC warns.

“Similarly, doctors from Moray having to travel to Aberdeen to see patients that are housebound, and vice versa.”

The group says the pressure has been building for several reasons:

  • A lack of GPs
  • Problems with recruitment and retention
  • A rising workload

It’s pointing the finger at “a blatant and shameful lack of support from Scottish Government.”

Pleas for help ‘repeatedly declined’

The GPs say there are “simply not enough of us” to treat the number of patients required.

Last year we reported that the north-east has fewer doctors per person than the Scottish average – and some of the largest practice lists.

At the same time, clinics are being encouraged to open for longer and offer more services to ease pressure on other parts of the NHS.

Dr Bhana, who works at Elmbank, and Dr Fenwick, of Holburn Medical, say their pleas for help have fallen on deaf ears.

“The Scottish Government have made it very clear through their actions (or lack of) that they just don’t care,” they said.

Dr Bhana says their requests for help from the Scottish Government are going unanswered. Image: Kami Thomson/DC Thomson

Requests to freeze movement between practices, allowing them to prioritise patients new to the area, have been turned down several times.

As have calls for financial protection for the “already struggling” practices unable to keep up.

The group says some clinics are being “forced” to hold extra surgeries in evenings and sometimes weekends, despite not having enough staff during core hours to operate safely.

“Insult to injury,” the doctors added, “they then face significant financial penalties for not providing these services resulting in further destabilisation and a vicious cycle.”

Failing to meet extended hours requirements, for example, would leave them short around £3 per patient.

In a 10,000-strong practice, this would be the equivalent of one staff member’s salary.

‘Frail, elderly and complex patients will suffer’

As it stands, the Grampian LMC says large numbers of patients across the region will suffer because of the “unprecedented and unmanageable” demand for GPs.

“Many of them are unable to offer their frail, elderly and complex patients the chronic disease monitoring that they need to remain well and active in the community,” they said.

They’re also experiencing a knock-on impact of wider NHS pressures.

Increasing backlogs mean GPs are spending more time helping people manage “troublesome and distressing” symptoms while they wait for specialist care.

The group said: “This may be manageable in the short term.

“However, in the long term, it pulls GPs away from their role as expert medical generalists for our frail, elderly and complex patients.”

A Scottish Government spokeswoman said the country has a record number of GPs with more per head than the rest of the UK, and it’s working to continue attracting and retaining more.

“We are on track to deliver on our commitment of 800 additional GPs by end of 2027,” she added.

“We have significantly increased physiotherapy, pharmacy and nursing support to practices, as set out in GP contract, through the recruitment of 3,220 additional staff and are continuing to grow this workforce.”

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