A radical shake-up of GP working conditions in Tayside could have severe unintended consequences for paramedics, a union has warned.
The Tayside Primary Care Improvement Plan (PCIP), is an ambitious redesign of primary care services jointly developed by Angus, Dundee and Perth and Kinross health and social care partnerships, NHS Tayside and GPs.
NHS Tayside has described the plan as a response to the new GP contract, which was introduced in April.
It is designed to use the experience and expertise of health care professionals to their “upper limit”, using staff including pharmacists, physiotherapists and paramedics to carry out some work currently undertaken by GPs.
This would free up time for doctors to better manage their workloads.
Fears have been raised, however, it could encumber workloads of other health care workers, with paramedics in particular concerned about where extra resources for staff would come from.
They are already stretched to the limit during peak times, according to John Marr, secretary of the GMB Scottish Ambulance Service branch
He said: “As we know, waiting times during the winter were horrendous and crews are constantly having their responsibilities increased.
“We know the workload is increasing on our members, but resources do not seem to be.
“We have and are calling for more resources to be delivered so people can get the ambulance service they deserve.
“If paramedics are out doing house calls, who is going to be taking people to hospital?
“The ambulance service is still who everyone relies on to take patients to hospital – members of the public, other health care professionals, the police – but if paramedics are having to do extra work without proper resources, who is going to do that?
“We are very concerned about the impact this could have on our members.
“They can dress this up how they like but this won’t solve workload or waiting time problems.”
The PCIP is due to go before NHS Tayside board for approval next week.
Dr Michelle Watts, associate medical director of primary care at NHS Tayside, said: “One of the key aims of the plan is to attract more doctors to the profession by creating more fulfilling roles.
“By further developing the multidisciplinary team connected to practices, it is hoped that doctors can refocus on their senior clinical leadership role within the community.
“This will free up capacity to manage the more complex problems and allow for new roles to be created for health professionals to be part of multidisciplinary teams supporting patient care which is safe, more person –centred and delivered as close to home as possible.
“As a nation we require a strong and thriving general practice at the heart of our primary care system.
“The vast majority of healthcare contacts for people start and end within primary care, with general practices acting as a gateway to decisions about referral, admission and treatment which have a direct impact on the entire health and social care system, so it is essential that we get this right.”
The Scottish government has approved £3.6 million for 2018-19.
Dr David Shaw, clinical director for Dundee health and social care partnership and co-author of the plan said: “The plan describes better designed, better funded services provided closer to where people live.
“It will take work away from a stressed General Practice system which should help free up GPs to offer the necessary expert advice required for both patients and the wider teams that care for patients.
“It represents a significant investment in primary care within Tayside which will help develop the range of services offered by our physiotherapists, pharmacists, nurses and other healthcare workers.
“It is a tremendous opportunity to advance the quality of healthcare patients receive.”