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Access & capacity review


A review is being commissioned into patient need for primary care services in Musselburgh, and whether this need could be better met. The review will listen to patient concerns, look at access at Riverside Medical Practice, and the capacity of both the Practice and East Lothian Health & Social Care Partnership (ELHSCP) services to meet patient demand.

All acknowledge that the care our team provide at Riverside is of extremely high quality, but we are very aware that there isn’t enough of it to go around – and of how frustrating and upsetting this is for patients.

We have for some time now been letting local stakeholders know that demand – for GP appointments primarily – exceeds our capacity to provide those appointments.

This is despite our clinical team being well staffed in line with observed averages at other GP Practices, and providing as many appointments each day as they safely can. We believe that our call handling and administrative teams are similarly at capacity.

So we hope that the review panel will assess whether any recommendations can be made that we and others can work on together, which may lead to our patients’ needs being better met. We look forward to working closely with the review panel, throughout the process, and to being strong advocates for our patients.

Of course, we are unfortunately far from the only Practice in Scotland to be in this position. A recent BMA Scotland study showed that 83% Practices in Scotland said that demand was exceeding capacity, with 42% saying that demand substantially exceeded capacity and just 4% saying that capacity exceeded demand.

We believe there has been an access issue in Musselburgh stretching back to the time when there was the third (Eskbridge) Practice in the town. We took over the care of the 9,000 Eskbridge patients from NHS Lothian in 2018 in the genuine hope of providing a better service for them, with increased support from our colleagues in the CWIC team and at NHS 24. But despite the best efforts of all those involved, patient concern about access has never gone away. And as we’ve seen right across the NHS, access issues have been hugely exacerbated by the pandemic.

As we hopefully start to edge away from Covid, this external input will sit well alongside the initiatives we continue to work on at the Practice with the aim of improving access as much as we possibly can. In an extremely competitive jobs market we’re delighted to have recently recruited four new GPs, who joined our already-strong clinical team of 17 GPs, five specialist nurses, our specialist paramedic, two treatment room nurses and three phlebotomists.

We also continue our work to explore whether any digital tools could provide patients with alternative ways to contact the Practice and access some services – making sure these are as inclusive as possible and reflective of patients’ needs.

We want the very best for our patients and are committed to being here in Musselburgh for them, now and in the future.

Drs Cameron, Fairclough, Stenke & Kitto
GP Partners
Riverside Medical Practice

Additional comment from Dr Andrew Cowie, deputy chair of the BMA’s Scottish general practitioners committee:

“We know GPs are under severe pressure across the whole of Scotland – and there is no doubt this mismatch between demand and capacity is a serious issue for Practices like Riverside.

“There will also of course be a range of local circumstances that impact on all Practices, some of which appear to be particularly acute in Musselburgh.

“Like the Practice, we welcome this review – and hope that it is carried out rigorously, looking at all factors impacting on access to GP appointments – and delivers the kind of improvements that help not only Riverside and their patients, but may also have wider learning which can help support Practices across Scotland to help their patients.”