There are nation-wide difficulties in recruiting GPs to practices, and there are an increasing number of practices that are unable to continue to provide services. Although this is a UK wide problem, it does seem to affect practices in rural areas more.
The High Street Practice in Moffat traditionally had 3 doctors. In January of last year with only two doctors in post one of them resigned. This left Dr Sharkey continuing to provide services by herself, supported by a number of locums. Successive recruitment efforts have not attracted any GPs to the practice to support her and she is now retiring from medicine. This leaves the surgery with no doctors.
The Health Board had hoped that we would be able to attract doctors to continue to run the practice as a partnership (i.e. in the traditional way), but we have not been successful. Consequently, with effect from 1 October 2016 the Health Board has taken on the running of the practice, and has arranged for the direct employment of all staff. We are currently recruiting two salaried doctors who will be supported by locum doctors as required.
In the interim, there are three doctors who we are employing as locums; Dr Richard Crosby, Dr Stan Tervier and Dr Michael Scullion who have all been working in the practice in recent weeks and who are familiar with the area. This allows us to continue providing a service across the practice area.
The Board’s medium term plan is that we will return the practice to the traditional partnership/sub-contractor arrangement, and in the longer term, we hope to support the merger of the two Moffat practices. This will result in a larger, and more sustainable, practice that we believe will be more attractive when recruiting young doctors, and may enable a greater range of services to be provided to patients.
There are however a number of changes that we propose to make within the first month or so of taking over the practice. These changes are essential to improve the efficiency of the practice and to make it more attractive for future doctors.
Currently around 800 patients of the practice live in and around Crawford, Leadhills and Wanlockhead. The practice has provided surgeries twice a week from all three of these villages, with patients going to the Moffat surgery if they require attention on other days. The surgery in Wanlockhead is delivered from the Community Hall. In Leadhills it is provided from a relatively recently constructed, purpose built building and in Crawford there is an older building maintained by Lanarkshire Health Board.
The Board is proposing that because of the difficulties in staffing the practice, we will move to delivery of services from the Leadhills Surgery only. As now, the GP surgeries will be held on Tuesday and Thursday with the surgery being open in the morning on each of these days for GP appointments. The practice nurse will be at Leadhills on a Wednesday afternoon and we are investigating the potential of providing a Pharmacist clinic to support patients on either Monday or Friday. This will mean there will be access to healthcare at Leadhills over a longer period each week.
In line with best practice, we are also working on more appropriate arrangements for the dispensing and supply of medicines in this area. Medicines will be available for collection when the Leadhills surgery is open on four days of the week.
Whilst it is appreciated that these changes may cause concerns in the local community, surveys have shown that the vast majority of patients access the surgeries by car (either their own, or those of friends and neighbours). It is also understood that patients from the Lanarkshire area access Moffat surgery on the days when the branch surgeries are not open. Whilst Crawford is approximately 15 miles from Moffat, journey times are relatively low due to access of the motorway.
In summary access to small branch surgeries in rural Dumfries & Galloway and South Lanarkshire is changing in order to make the working of the practice more efficient and help with the recruit GP partners in the future.
Each household of the High Street Surgery, Moffat, has been written to and patients in the affected communities are invited to one of three drop in sessions that have been arranged. At the drop in sessions Board officers will be discussing with patients how these changes might affect them and if there are measures that can be taken to minimise the impact of these changes for patients.
