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Private Notes
In the first episode, the focus is on the GPs themselves as they try to meet patient demand. A third of GPs aim to retire in the next five years, leaving Scotland facing a recruitment crisis. The Elgin Medical Centre is one of the few which has secured the appointment of a newly qualified GP. But since two of the practice's senior GPs hope to retire very soon, the challenge facing the staff is far from over.
Dr Ron Stewart, the longest-serving of the six full-time GPs, is one of those hoping to retire. The changes he has seen in his 32 years as a family doctor have been immense. Where once the local doctor was limited in what he or she could do for a patient, increased knowledge and increased patient expectations mean that the GP is busier than ever. Sticking to the recommended ten-minute appointment time is a challenge for both Dr Stewart and Dr Cattanach, despite their differing levels of experience.
As Dr Stewart deals with a patient with a long list of medical issues and another with long-term anxiety, Dr Cattanach has concerns that one of her patient's prognosis may be worsening. The daily challenges are brought into sharp focus with the unexpected announcement that another senior GP intends to step down, threatening the practice's long-term plans.
In the second episode, the focus is on those carrying out clinical duties which were once the sole preserve of the family doctor. The lack of GPs has forced medical centres like Elgin's to become creative in how they deliver healthcare to the community. One controversial solution is the use of emergency care practitioners, which in the case of Elgin is an advanced paramedic and an advanced nurse. They form an integral part of the duty team, dealing with unscheduled appointments and many home visits.
Among paramedic Kevin Reid's cases is a patient who has arrived complaining of severe chest pains. Concerned that he might have a serious heart condition, Kevin summons an ambulance from the local hospital.
Advanced Nurse Naomi Lodge visits an elderly patient with worrying symptoms. Her patient is one of several listed in the centre's 'virtual medical ward' - an innovative system designed to monitor their most vulnerable patients. Working alongside them is the busy district nurse team, who offer vital support in the community. Already short-staffed, the nurses suffer another blow with the resignation of their team leader and the news that she won't be directly replaced. Emotions run high at her leaving party, as do concerns on how they can maintain a service with dwindling resources.
In the final part of this three-part series, the behind-the-scenes access exposes the pressure points on every aspect of running a GP practice. Having taken over the surgery in the nearby town of Rothes that would otherwise have closed, the senior GPs face a hefty bill to get the building up to standard.
Dr Ron Stewart makes the journey to see patients at a temporary surgery set up in a rented house - but with staff off sick in Elgin, the system is badly stretched. Adding to the pressures on Scotland;s GP practices are increasingly complex or demanding conditions affecting patients. Obesity and unhealthy lifestyles take their toll, as does the significant increase in the elderly population living longer but often with poor health.
Up to 40 per cent of GP consultations involve issues of mental health, and Dr Graham Taylor must use all his experience to assess a patient who tells him he has been feeling suicidal. One of Dr Robert Lockhart's patients faces a long and worrying wait for neurological test results. As the senior GPs reflect on how they are managing to deliver a safe service for their 17,000 patients, a neighbouring surgery declares a crisis and a further 5,000 people could soon be looking for a doctor.
