The agreement of the new Scottish GP contract was brought to our attention in January by one of our members. Since then, SRA have been investigating the situation and have come to the conclusion that the new proposal has not been subject to an appropriate level of rural-proofing.
The new contract is intended to be a fair way to allocate funding to GP practices throughout Scotland. The aim is to improve the sustainability of primary healthcare across Scotland and is generally a welcome commitment from the Scottish Government. However, the formula fails to account for issues, interests or challenges that rural areas face.
The new contract has been decided using a ‘Workload Allocation Formula’ that allocates funding to practices based on consultation numbers. According to Professor Phil Wilson, Professor of Rural Health and Primary Care at the Centre for Rural Health in Inverness, the formula does not account for rural and remote aspects, such as the cost and supply of medical services (higher in rural areas).
The Rural GP Association of Scotland (RGPAS) has been campaigning to raise awareness of the new contracts and how rural areas are set to disadvantaged by the new funding allocations. RGPAS has created the image below that shows the practices in red that will receive no increased funding. The green dots show practices – overwhelmingly in urban areas – that will receive increased funding.
The practices in red will remain ‘income protected’ (which means they will not have their budgets cut) for the foreseeable future. However, SRA is concerned that this conclusion was reached without consultation with rural communities and adequate rural-proofing.
SRA wrote to Shona Robison MSP and sought reassurance that rural and island proofing had taken place to an appropriate level and expressed our concerns about the recruitment and retention of health staff. We received a response from a representative in the Primary Care Team that acknowledged rural practices do face unique challenges, and, that consultation with rural communities is essential. The response also highlights the formation of a ‘Rural Short-Life Working Group’ that will be formed in April 2018. The working group will consider matters relating to implementing the contracts in rural areas. It was indicated in the response that membership will include a wide-range of representatives from remote and rural communities from across Scotland. The purpose of the group will be to ‘consider matters relating to implementing the contract’.
Unfortunately, this is not a substitute for a thorough and inclusive rural proofing process prior to the contract being confirmed, and on this matter, we did not get a full or satisfactory response from Scottish Government.