The Scottish government has asked NHS boards to look at moving staff in non-essential roles to support out-of-hours GP services in the event of a severe escalation of coronavirus.

A letter setting out the process for suspending GP services warns of ‘significant capacity challenges’ that will come from large numbers of patients turning up with flu-like symptoms and staff becoming ill.

Health boards are asked to draw up measures to support GP surgeries and out-of-hours services that will bear the brunt of first contact with patients.

Four new cases taking the total in Scotland to 27 were announced today, as a sixth UK patient dies after contracting the disease.

Jeane Freeman told MSPs there is no evidence of community transmission in Scotland and all the cases are linked to travel to at-risk region or contact with known case.

There are three levels of escalation, ranging from cancelling appointments all the way to ‘full suspension of services’.

GP practices ‘may wish to consider how administrative or reception staff can start this process should all the practice clinical and senior staff become unavailable’, the document states.

Surgeries in more remote areas with one or two doctors are of particular concern.

NHS boards are also being told to boost out-of-hours services as these will have an ‘important strategic role”’ in the primary care system’s response to Covid-19.

The paper warns that closures elsewhere in the system could load pressure on to out-of-hours services and leave them ‘severely compromised’.

NHS boards should release staff in non-essential roles to support night-time and weekend GP services, it states, and they should consider reducing pressure by ‘retaining GP services within the A&E environment or….when large numbers of patients are presenting with symptoms associated with Covid-19.’

Last month services across the Glasgow area were suspended due to staff shortages, with bosses blaming an ongoing row about NHS pensions.