NHS boards will have to look beyond GPs to provide primary care out of hours if services are to be sustainable, Audit Scotland has warned.
In a report published today, the watchdog says fewer GPs are prepared to work overnight sessions. This is partly because their income has gone up under the new contract so the fee is not attractive enough.
Mainland boards pay GPs an hourly rate of between£50 and£80.91 for cover out of hours, but GP pay in Scotland increased by 24.9 per cent to£82,696 between 2003-04 and 2004-05.
The report, Primary Care Out-of-Hours Services, says 80 per cent of patients are happy with out-of-hours services.
But it warns that boards are finding it harder to fill rotas, as the number of GPs from opt-out practices who provided some level of out-of-hours care for a fee fell from 1,696 in 2004-05 to 1,440 by 2006-07.
Deputy auditor general Caroline Gardner said: 'The way the service is currently delivered needs to change as there is a significant risk that it is unsustainable in its current form, particularly in Scotland's rural and remote areas.
'The Scottish Executive should look to health professionals other than GPs and consider how to extend their roles and skills.'
The report can be found at www.audit-scotland.gov.uk.
Special health boards will not be relocated
Unions have welcomed an announcement from public health minister Shona Robison that three special health boards will no longer face relocation from Edinburgh to Glasgow.
The previous Labour-led administration had planned to relocate the headquarters of NHS Health Scotland, NHS Education for Scotland and NHS Quality Improvement Scotland.
Ms Robison said the move would cost around£22m, which could be better spent on frontline services.