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The NHS – What’s going on

The following is an article recently created for NHS patients from the Lothian Local Medical Committee. You can also download a PDF copy of this article using the link.

Why are your GP practices now unable to do everything they once were?

General Practice across the country has been struggling for years.  However it has now reached a critical situation with less money, less doctors and less staff to meet the growing needs of the Scottish population. So how did we get here?

In 2017, the Scottish Government recognised this and promised to introduce a new contract, starting in 2018 and to be fully implemented within 3 years. At the time, the then Health Secretary Shona Robison MSP (now Deputy First Minister) said “We equally recognised the fundamental challenges faced by general practice, not least growing workload and increasing risk”.

Unfortunately, for the first time in the history of the NHS, large parts of this contract have not been implemented. Even worse, when Health Boards haven’t been able to spend the money that they were given to employ additional pharmacists and other professionals to support General Practice, the money has had to be returned to Scottish Government rather than being able to be spent supporting your local practice.

Scottish Government promised transitional payments to practices to recognise the non-delivery of this contract, but then withdrew that funding, even after some practices had already used the money for additional cover.

There have been many further challenges both local and national since then;

  • Over half of the practices in Lothian have recently received huge bills for their facilities from NHS Lothian, over and above what they were already paying. This will amount to £1.6 million per year across the practices affected and, without any additional funding coming into practices, it’s likely this will lead to reduced staffing, with fewer appointments and longer waits to be seen.
  • All practices in Lothian are impacted by Scottish Government not funding an increase in compulsory pension contributions. This is only occurring in General Practice in Scotland as English and Welsh Governments have already committed to paying this, and there is funding in place for all staff in hospitals. Again, this comes out of the funding available to practices to pay for administrative staff, nurses and doctors.
  • Many people don’t know that the funding for practices comes through a national formula and doesn’t reflect how many times patients are seen. Practices are paid the same whether you are seen once or a hundred times per year. In 2017, the Scottish Government recognised that it wasn’t sufficient and promised to move towards a new funding model. This still hasn’t happened, and the funding uplifts have been substantially below inflation since then.
  • The average patient used to contact their practice 3-4 times per year. This has increased to 6-7. The reasons for this are multiple and include more elderly, more people with illness (often multiple) and more treatment options. The large growth in waiting lists has also had a big impact, with GP appointments being taken up with ongoing management whilst awaiting definitive procedures.
  • We all know how much energy costs have risen over the last couple of years and with insufficient funding to cover this, again this money comes out of the services practices can provide.
  • Part of the funding which comes from government every year is earmarked for non-GP staff pay rises e.g. receptionists, nursing staff, practice managers. This has always matched what was given to staff working elsewhere in the NHS. But for the first time last year, the Scottish Government decided to break this link, meaning practices had to fund the shortfall or risk losing staff.
  • The number of GPs in Scotland is falling. As part of the 2017 contract the Scottish Government promised that numbers would rise by 800, however when doctors in training are excluded from the figures, the numbers are actually reducing! Since 2013, the GP WTE (whole time equivalent) workforce has fallen by 5.35% – a fall of 196.7 WTE GPs. In that same time period, the number of practices has fallen by 9%, average list sizes have increased by 18% and the total patient population has increased by 7%. 42% of practices in Scotland report at least one GP vacancy. The number of GP partners has reduced by 14% between 2012 and 2022. In the last 20 years the ratio of GPs to hospital consultants has halved, despite many things which used to be done in hospital now commonly being done in practice, and this reflects the falling share of the NHS budget spent in General Practice.
  • In many areas, practice buildings are too small and are outdated. Unfortunately, Scottish Government has now cancelled all funding for new builds, leaving many working out of buildings no longer fit for purpose. Scottish Government has also withdrawn sustainability loans, a scheme to reduce the risk for GPs who own their building. This leads to financial loss which again impacts on the services they can deliver.
  • With less staff and more work, better IT would help improve efficiency. Our IT is cumbersome and unreliable which often impacts on the care of our patients, increasing inefficiency and damaging staff morale. We are the only country in Britain still using paper prescriptions – this alone costs a huge amount of clinical, administrative and patient time.
  • In order to make systems better we need time to learn and develop. We used to receive ten half days per year to work with our teams on making practices better for everyone. The support for this was withdrawn by NHS24 and Scottish Government have done very little to reintroduce any form of reliable support.  

Incredibly, despite all that we have just described, your practice remains absolutely committed to provide the best service that it can.

However, if you’re not satisfied with the service you receive, look beyond the practice and instead hold those with the power to improve matters to account. Scottish Government needs to do more to directly support General Practice, the bedrock of the NHS.  Please contact your MSP.  Their contact details can be found at Members of the Scottish Parliament (MSPs) | Scottish Parliament Website

Lothian LMC

May 2024

Newtongrange Surgery Update

To All Our Patients

It is with great regret we have taken the decision to permanently close Newtongrange clinic. This was opened in 2018 following the conversion of the old health visiting building. It has been used since to offer GP, physio and nursing clinics. It was not proving as popular as our main site at Newbattle due to the lack of any parking but ideally we would have continued to use it to offer more clinical space and easier access for those in Newtongrange village.

However, due to major cost increases announced by NHS Lothian to service the building we have had no option but to close to protect our clinical service. As it is an NHS owned building the GP Partnership has to accept NHS Lothian’s Estate Services for cleaning, maintenance and utilities. They proposed increasing the costs onto the GP Partnership by over 330%! This forced us to make the difficult choice between keeping the building or reducing our staffing. As you are aware we are a very busy Practice so reducing our staffing is something we will never look to do as it would have a detrimental impact on the care we can provide. We understand this will be disappointing to patients, especially those within Newtongrange but we hope you can understand our decision.

With significantly more buildings planned in the area it is hugely frustrating we are being forced to reduce our premises but until the funding into General Practice and the NHS in general improves we fear more reductions like this are inevitable. We will strive to protect services for you all as best we can and hope that better times are to come. Many thanks for your understanding.

Kind regards,

Newbattle Medical Group

Patient Notice

General Patient Notice:

Newbattle Medical Group, along with the vast majority of General Practices across Scotland is under immense pressure to sustain services to the community. As a result of the demand on all of our services , we are having to make adjustments to how we operate which may have an impact on how you currently use our service.


Why is this happening?

There are a number of financial pressures being placed on the practice meaning that there is less money to invest in frontline staff. In 22/23 and 23/24 Scottish Government decided that GP administrative staff were not to be uplifted in line with equivalent hospital staff. We protected our staff from this but this leads to a significant shortfall.  For the last two years of very high inflation our expenses uplift has been no where near the true cost of the rise in goods we must purchase (medical equipment, stationary etc). We have also been served with notice by NHS Lothian to meet the significant inflationary uplift to services they provide, such as building maintenance and cleaning.  This combination means we have far less money to support the community with frontline clinical and administrative staff. Worse still, for 24/25, NHS Lothian have been told by Scottish Government to cut their budget by 7%. This means the likelihood of any direct support for General Practice to assist us with these challenges is highly unlikely.

This financial backdrop is making an already difficult situation worse. Scotland has one of the most unwell populations in Europe along with a massive growth in the elderly population, meaning demand for healthcare is rocketing whilst the available workforce is dropping.


What will be changing?

Currently we provide eConsult to our patients 24/7. We are required to reduce this to 0600-1900 Monday to Friday. This will ease some of the pressure on our administrative team and allow us to concentrate our working hours within the standard working week. In the future, we may also be required to introduce a cap on the number of eConsults that we process each day. We will continue to operate a 24/7 service for repeat prescription requests.


What is the impact on me?

In the out of hours period we would encourage you to visit or call 111 rather than use eConsult. We remain committed to keep eConsult open either side of normal hours to help and support our working population. However, you may also experience eConsult not operating during a very busy day. If this is the case, if you cannot wait to complete an eConsult the following day, then please call the practice where we will assist on a needs first basis.

Please be assured, all our team will continue to strive to provide the best care and support to patients. Our administrative team will continue to help guide you and support you whenever looking for care. Please be supportive of them too; the rates of abuse to staff has risen and this will not be tolerated. To give you more of an idea on the pressures we face we would encourage you to read this article published very recently. Ben Shankland is a GP, but the rightwing press would tell you he’s an enemy of the people. Don’t listen | Polly Toynbee | The Guardian


Many thanks for understanding and patience throughout this difficult time.

Newbattle Medical Group

Festive Opening Hours

We are OPEN every day over the Christmas period except for the national Christmas and New Year bank holidays.

eConsult will be in self care mode from midday on 21st December until 9am 2nd January.

Please call the practice as normal if you have an urgent medical problem on the 21st or 22nd December.

If you have an urgent medical problem between 27th and 29th then please do not call the practice – we will be operating Emergencies Only walk in clinics (9-11am and 2- 4pm) for anyone who has an urgent medical issue and who feels they need to be seen.

From all at Newbattle Medical Practice we wish you a Happy and Healthy Christmas.

ASN Flu Vaccination Sessions

Childhood Flu Vaccines

Midlothian 2-5 year Nasal Flu Drop-in Sessions

We would like to make patients aware that seasonal Flu Vaccines are currently still available as drop in sessions throughout November around Midlothian. Dates can be found below:

1/11/23 Loanhead Library 08:30 – 16:00
1/11/23 Newbattle Library 08:30 – 16:00
3/11/23 Gorebridge Library (Venue TBC) 08:30 – 16:00
18/11/23 IKEA Loanhead 10:00 – 16:00

If you receive an appointment for one of the above clinics and are unable to attend but able to attend another please bring along your original letter and we will be able to assist you.


ASN Vaccination Sessions

Does your child have ASN? Midlothian are pleased to announce that they are running sessions for vaccinations in a calm, relaxed environment at Bright Sparks in Bonnyrigg.

Please contact your HV for further details or 07970 297 939 for further advice.

IT Systems Scheduled Maintenance

Important Patient Notice

Please be aware that our IT systems will be receiving essential maintenance work on Thursday 3rd & Friday 4th August.

During that time, we will be unable to process prescriptions, or access patient medical records.If you do run out of a repeat prescription on the 3rd or 4th August, then your usual pharmacy can supply a small amount and should be contacted first.

We will be available on the 3rd & 4th August for emergency medical problems only. Please help by visiting or your local pharmacy first, and only contact us on those days if your problem cannot wait until Monday 7th August.

eConsult will be available as normal until Wednesday 2nd August at 17:00 and from Monday August 7th.

Thank you all for your support and understanding.

Danderhall Medical Practice – Update

Over the past 6 months, Newbattle Medical Group has been helping support Danderhall Medical Practice deliver GP services. We are delighted to announce that from 1st August Danderhall Medical Practice will formally become part of Newbattle Medical Group.


What does this mean to me?

Very little will change from how you currently use our service. However, if you are keen to see a particular GP, you may be offered a quicker appointment with that GP if they are based in Danderhall on a particular day. There will be no obligation for you to travel and if this is not possible you will be offered their next available appointment at Newbattle or Newtongrange. The additional support provided by the HSCP means we will be upgrading our phone system to make call handling faster, leading to shorter call waits. We will also see additional staff join the practice to provide more access to our patients. We

Danderhall Medical Practice

Newbattle Medical Group will be taking over the running of Danderhall Medical Practice from the 20th February 2023 for a minimum of six months. There will be no reduction in service at Newbattle and none of our doctors will be moving to Danderhall permanently. However, some of our doctors will be working over both sites on a regular basis, meaning the availability at Newbattle may be slightly reduced. We are delighted to have recruited some new doctors to help at both sites and look forward to serving the community at Danderhall.

Children’s Flu Vaccinations

If your child has missed their appointment, for nasal flu please feel free to attend any of the following clinics, it is important that you bring your child’s original appointment letter with you 

 24.10.2022 Woodburn Miners Club 1pm-4pm
26.10.2022 Loanhead Library 1pm – 4pm
28.10.2022 Loanhead Library 1pm – 3pm

 These are our last remaining clinics so please attend

 If you have any queries relating to your arranged appointment, please call   07773 745 315

Latest NHS Flu Vaccination Programme

Latest NHS Vaccination Programme.

Scotland’s winter vaccination programme is now underway, with frontline health and social care workers and those aged 65 and over among the first to be invited for their COVID19 and flu vaccines.

A new campaign aimed at all groups eligible for vaccination will launch soon, but in the meantime, your support in reaching those currently being called forward would be greatly appreciated.

You can find out more about the 3 groups covered (Children 2-5, School Children and Patients at high risk or over 65) by using the links below.

Childhood Flu  2 – 5
Year-olds T

Download the official
NHS PDF Info Sheet

School Children’s
Vaccine Toolkit

Download the official
NHS PDF Info Sheet

Health & Care Workers
Vaccine Toolkit

Download the official
NHS PDF Info Sheet