Exclusive:SNP walk-in GP clinics 'completely unaffordable' as experts call for evaluation of pilot project
As GPs face increasing pressure on services, experts say the SNP’s walk-in clinics will do nothing to ease the strain
Medics have warned Scotland’s GP services are in a “perilous position” and that walk-in clinics are “completely unaffordable”.
Doctors across the country report unsustainable workload pressures while patients are frustrated by a lack of appointments.
In response, the Scottish government has pledged £36 million to open 30 walk-in GP surgeries around Scotland.
However, Dr Iain Morrison, chair of the BMA Scottish GP Committee, said walk-in centres will be “exposed as being completely unaffordable”.
He described the cost per patient interaction as “massive” at a time when other areas of the sector are looking to be as financially prudent as possible.
Both the SNP and Scottish Labour have vowed to “end the 8am rush” for a GP appointment as key manifesto pledges ahead of next month’s election.
But Dr Morrison said the issue of access has become too much of a focus when quality of and continuity of care are vital to overall health outcomes for patients.
He added: “Walk-in centres become an incredibly inefficient way to deliver healthcare if you don't have continuity.
“They are a distraction from the need for long-term strategic planning rather than a short term pilot.”
Patients who are seen in the walk-in centres but who need further care will be referred back to their core GP practice.
Dr Morrison said there is also a risk of poor communication between the walk-in centre and GP surgeries that lead to missed follow-ups.
He also said GPs face an emotional strain of not being able to fully serve their patients.
“There is a moral injury that's taking place when you know that services should be better and you can do better, but because of resourcing, it's impossible.
“That's a huge issue with the morale of the workforce.
“When patients get rightly frustrated, they take out on our staff. The abuse our staff gets is horrendous at times.”
The pressures on GP services are further illustrated by the fact Scotland’s health boards spent at least £10.7 million on locum GPs last year, new figures obtained by The Scotsman show.
Asked how much each health board had spent on locum cover since 2016, each of the 14 health boards provided sums totalling £144.7m over the past decade.
However, the figure will be much higher as some health boards provided only their spend on 2C clinics - those run by the health board - without including out of hours numbers.
Dr Morrison said GP provision is in a “pretty perilous position” but a new three-year funding restoration package agreed between the Scottish GP Committee and the Scottish government should assist.
“We see this three-year funding deal as a restorative phase, and then beyond that, we need to really look at significant further expansion of general practice in order to meet the needs of the Scottish population,” Dr Morrison added.
Sandesh Gulhane is a Scottish Conservative election candidate and practising GP.
He said medics firmly believe walk-in clinics will not help alleviate deep seated problems.
GP walk in centres will lead to “losing continuity,” Dr Gulhane added. “You're losing the safest form of healthcare, the cheapest form of healthcare” by creating what he called an “out of hours service in hours”.
“My solution is, we would directly invest in GPs and ring fence the money specifically for more GP appointments,” he added.
“There's multiple ways of doing that but it is vital the money is ring fenced.”
RCGP Scotland's Vice Chair (Policy) Dr Chris Williams said the Royal College of General Practitioners (Scotland) does not support GP walk‑in clinics.
He pointed to “overwhelming evidence” from England where walk‑in clinics were trialled and ultimately unsuccessful.
“There is no evidence that GP walk‑in clinics reduced pressure on core GP services or A&E departments in England, and there is no reason to believe they will do so in Scotland,” he said.
"Walk‑in clinics do not address the root cause of problems with GP access: patient demand significantly outstrips the capacity of general practice.”
Since 2013, the number of whole‑time equivalent GPs in Scotland has fallen by 2.3 per cent, while the number of registered patients has increased by 8.8 per cent.
Dr Williams added: “Based on the information available, the pilot GP walk‑in clinics in Scotland offer a narrower range of services than core general practice, at a higher cost.
“They also fail to deliver one of the greatest strengths of general practice: continuity of care.
“The trusted, ongoing relationship between patient and GP is proven to reduce mortality, improve adherence to medical advice, and lower hospital admissions and A&E attendances.”
When the pilot was first announced by the SNP, 15 walk‑in clinics were expected to deliver one million appointments.
The Scottish government then doubled the number of pilot sites to 30 when it became clear the target figure would not be met.
“In our view, this represents doubling down on a pilot scheme that has yet to demonstrate meaningful results,” Dr Williams added.
He called for the next Scottish government to subject GP walk‑in clinics to a rigorous and transparent evaluation.
“If that evaluation confirms - as we expect - that walk‑in clinics provide fewer services at greater cost, then the funding and staff currently committed to the pilot sites should be redirected to where they can have the greatest impact for patients: strengthening core general practice,” the medic added.
First Minister John Swinney opened the country's first GP walk-in clinic at Wester Hailes Healthy Living Centre in February.
New figures obtained by the Scottish Conservatives show that from February 22 to March 22 some 987 people attended the GP walk-in clinic in NHS Lothian.
The average waiting time for a patient to be seen was 42 minutes, with the longest wait being more than six hours.
They found only one GP per shift operates within the clinic.
Emma Harper, SNP candidate for Galloway and West Dumfries, said: "The SNP is driving forward improvements in our NHS, working in partnership with GPs to improve access and tackle the 8am rush.
“We reached an historic deal with GPs which will see over half a billion pounds invested in general practice, including to recruit and train more GPs.
"Under the SNP, the NHS workforce has increased significantly and the number of GPs is continuing to increase, with more GPs per head in Scotland compared to anywhere on these islands.
“The SNP has a bold plan for our NHS and it is working - waiting times are down, operation numbers are up, and we are opening GP walk-in centres all over Scotland.”
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