Most Scottish GPs are concerned about the impact of poverty on their patients in the coming months, RCGP Scotland has warned.
GPs in Scotland say they are seeing increasing numbers of patients impacted by poverty, as a report calls for action to tackle health inequalities.
Seven in ten GPs surveyed by RCGP Scotland said they had seen an increase in the number of presentations that could be linked to or worsened by poverty in 2024 compared to the previous year.
Another 22% reported seeing a significant increase in those presentations. Overall, 83% of respondents said they were concerned about the impact of poverty on their patients in the coming months.
In response, RCGP Scotland called for more investment in general practice to tackle growing health inequalities with a particular focus on those serving the most deprived communities.
GPs in the most deprived communities are more likely to treat patients with complex and additional health care needs, have a higher risk of burnout, and report significantly lower job satisfaction levels compared to those working in the least deprived areas, its report found.
And despite the Scottish Government’s stated aim to reduce health inequalities, GP practices in the most deprived communities continue to have lower staffing levels while managing greater patient demand and unmet need, RCGP Scotland added.
The report points to a gap in healthy life expectancy of 25 years for men and women between the most and least deprived areas with double the likelihood of death for a wide range of health conditions.
Drugs and alcohol also continue to be powerful drivers of premature ill health, the report said.
But according to the Health Foundation there is a ‘persistent and growing implementation gap’ in getting in place the measures that are needed including investment in general practice, RCGP Scotland said.
It called on the Scottish Government to increase investment in general practice to at least 11% of the NHS budget.
This should happen alongside a review of funding streams and resource to channel spending and workforce to practices based in the areas of greatest deprivation, it added.
In terms of the GMS contract, there should be routine questions about whether health inequalities are being reduced in line with one of its explicit aims, ‘and if not why not and how can we change going forward’, the report noted.
Other recommendations included teaching about health inequalities from the beginning of medical careers, a Scottish fellowship for GPs working in deprived areas, and better data and analysis of GP workforce and workload data around practice deprivation status.
And GPs should have the time and resource for reflective practice ‘in recognition of the high emotional labour of working in deprived practices’, it concluded.
RCGP Scotland Chair Dr Chris Provan said: ‘Health inequalities dominate the Scottish health landscape and have widened over the past few decades.
‘Those living in the most deprived communities are significantly more likely to die from conditions that are potentially preventable.
‘The Scottish Government has a clear understanding of health inequalities, but its persistent implementation gap means we have not yet seen the progress we need.’
He added the evidence shows that a robust primary care service with general practice at its heart will deliver better health outcomes.
‘That is why we are calling for the Scottish Government to commit to increasing general practice funding and workforce, with a review of additional resource to be allocated in line with proportionate universalism principles.
‘Without action from the Scottish Government on the recommendations in this report, the cycle will continue.’
A Scottish Government spokesperson said: ‘We are investing £3 billion a year on measures to tackle inequalities, poverty, and the cost of living crisis which can lead to health inequalities.
‘We have significantly expanded the primary care multi-disciplinary team workforce, with over 4,900 staff working across key services, including Community Link Workers, as at March 2024. And we are working to increase the number of GPs in Scotland by 800, by 2027.
‘Through our Child Poverty Practice Accelerator Fund we are supporting innovative local projects to tackle child poverty. This includes projects to help families access health services and to increase advice on financial inclusion in health settings.’
