Doctors in Scotland have asked the British Medical Association to consider alternatives to the troubled 2018 GP contract – shortly after the health secretary said he was “absolutely committed” to the agreement.

The contract was supposed to reduce workload by moving some services to health boards and bringing in teams of other health professionals to support each practice.

However family doctors are concerned about slow progress, saying a shortage of staff, insufficient funding and the pandemic meaning the deadline for implementation has been pushed back several times. The transition is now due to be completed next April.

At the BMA’s Scottish Local Medical Committee conference today, GPs backed a call for alternatives and said they had “lost confidence” in the Scottish government at today’s Scottish local medical committee conference.

The 2018 contract, which was backed by more than seven in ten GPs on a low turnout of 39%, aimed to make general practice more attractive by reducing workload.

This was to be done by recruiting a wider range of professionals, such as nurses and pharmacists, to surgeries.

Meanwhile tasks such as routine vaccinations and routine management of people’s medicines that could be done elsewhere were to be passed to health boards.

Both aims have been hit by delays, with the deadlines for service transfers being missed and a shortage of staff hampering efforts to recruit pharmacy teams.

Concerns were raised that local health and care partnerships have received less than half of the funding needed.

Health and Social Care Secretary Humza Yousaf admitted to the conference implementation has “not moved at the pace we would have liked to”.

But responding to questions, he said: “I’m absolutely committed to the GP contract as things stand, that’s why we’re not discussing what Plan B looks like.”

The Health Secretary added: “I absolutely reaffirm the Scottish government’s commitment to fully implement the contract…we will fully fund the promises and commitments we have made.”

Shortly afterwards, GPs backed a motion stating the changes were not reducing workload ‘in any significant way” and asking the BMA’s Scottish General Practice Committee to consider alternatives.

Also passed was a motion stating they had “lost confidence in the government” due to failings on the contract, covid-19 and face-to-face appointments.

Dr Neil MacRitchie, who supported the contract when it was mooted more than four years ago, said the overall picture was “very patchy” and GP workload had not reduced as promised.

Another speaker said a failure to recruit additional staff had left them “bearing the brunt” of rising demand, while others complained it had taken years for partial changes to take place. In Glasgow, for example, one GP said the travel vaccination service, which did not need to be delivered by GPs, was yet to transfer away from general practice.

Speaking at the start of the conference, Andrew Buist, chair of the BMA’s Scottish GP committee, said: “Workforce supply across primary care is a problem, the new community services have been significantly held up by a lack of available healthcare workforce; this is something the Scottish Government urgently needs a credible plan to improve on. 

“We need the physiotherapists, the pharmacists, the nurses, who are all key parts of the multi-disciplinary teams, we them need in place if we are truly to deliver the vision the contract sets out.

“The pandemic has only underlined the importance of all professionals working closely to deliver the right care to patients from the right person – so we need proper strategic planning and a redoubled focus on delivering these staff to support practices across the country, and we need that urgently.”

Read more: First stage of GP recruitment drive stalled; ’No target’ for face to face GP appointments; GP contract causing pharmacist "workforce drain"

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