PRESTONPANS Group Practice is facing a 10 per cent loss in funding, which, practice doctors have said, will lead to thousands of GP appointments being lost per year and potentially months of waiting times for patients.

Representatives from the practice attended a meeting of Prestonpans Community Council to discuss the issue.

Dr Zain Kapasi, a GP at the practice, said: “We have come along to make our community aware that, despite a constantly increasing workload, we will have almost 10 per cent less money per year available to provide services over the next couple of years.

“The financial pressure we are now experiencing is caused by political decisions taken at various levels.”

Dr Kapasi said that promises by the Scottish Government which would have ensured more medical professionals supporting the practice had not been delivered.

He added: “We were promised a variety of professionals would be funded to come and work alongside us as part of a primary care team. The only aspect of this that has been fully delivered has been vaccination services. We are not asking for more than was promised, but simply for the delivery of what was promised.”

Dr Kapasi also took aim at East Lothian Health and Social Care Partnership (ELHSCP) for withdrawal of £90,000 worth of funding per year, which had been secured in 2021.

He said: “We attended a (Prestonpans) community council meeting in June 2021 and explained that ELHSCP had offered us substantial support for same-day appointments, but only if we agreed that this service would be based in Musselburgh. We believed that this would worsen health. Support from the community council chair, along with support from Paul McLennan MSP, was crucial in enabling us to secure funding to provide appointments in Prestonpans. We employed a new salaried GP and practice nurse. With the additional capacity, our skilled practice nursing team have been able to undertake a variety of planned review appointments that would traditionally have been undertaken by GPs.

“This has enabled us to continue to offer pre-bookable appointments despite ever increasing primary care workload. This funding will cease from 1st October 2024 and we have no other means to generate income.”

Finally, Dr Kapasi said an increase in facilities management charges from NHS Lothian, including cleaning, lighting and other maintenance costs, would see the group’s fee rise from £8,000 per year to £35,000 per year.

Jenny Long, director of primary care at NHS Lothian, said in response: “Charges to GP practices that contract facilities services from NHS Lothian have been frozen for some years. Due to the substantial increase in actual costs to the NHS, this is no longer sustainable and we have therefore reviewed the facilities management charges to ensure they cover significant rises in inflation, energy, staffing and other supply costs.”

Dr Kapasi said the £90,000 per year from ELHSCP provided 3,100 appointments per year, with the practice currently providing 600 GP and 200 practice nurse appointments per week.

He said: “As we will no longer have the capacity to meet the need for appointments each week, the wait time for pre-bookable appointments will rapidly stretch to weeks, then months, as the effects of these service cuts cause delays to see a clinician.

“It is likely that we will be forced to change to a book-on-the-day model. We will, therefore, lose continuity of care, and evidence shows that patients will then need to consult with their GP more frequently. It seems inevitable that, unless we can secure funding or clinical resources to maintain our appointment numbers, it will become difficult for our patients to have timely access to the primary care services they need.

“We are concerned this could lead to delays in the diagnosis of cancer and other conditions, and patients being seen in out-of-hours and accident and emergency settings, which are much more costly.”

Andrew Stevenson, vice-chair of the community council, said: “We have to stand together when things are tough. You can’t put a price on a life, life is precious and we must support this. I fully support us doing whatever we can to support you.”

DJ Johnston-Smith, chair of the group, said the group would discuss the issue furthervowed to discuss the matter further, with a view to taking further action.

An ELHSCP spokesperson said: “Currently all parts of the health and care system in Scotland are under considerable financial pressure. On March 28, East Lothian’s Integrated Joint Board agreed to a £10million financial recovery plan to deliver a balanced budget, which includes making changes to many HSCP services. The three-year, fixed term funding agreement between ELHSCP and Prestonpans Group Practice comes to an end in October 2024. The current financial situation means that ELHSCP cannot extend this agreement.”

A Scottish Government spokesperson said that, since 2018, the Scottish Government had expanded the primary care workforce, with over 4,700 staff including community link workers, pharmacists, physiotherapists and mental health nurses in post at March 2023.