Tag: primary care

GP plan ‘failing to deliver’

A Scottish Government agreement with GPs to improve general practice has failed to deliver on several of its commitments, says spending watchdog Audit Scotland.

The 2018 General Medical Service (GMS) contract aimed to address the financial pressures and growing workloads facing GPs, and to improve patients’ access to care.

However, seven years on:

  • the estimated number of whole-time equivalent GPs has fallen
  • pressure on general practice has increased
  • proposals to support GP teams with more nurses, physiotherapists and other specialists have moved more slowly than planned
  • and people report finding it more difficult to access care.

The Scottish Government has not set out how it intends to invest in general practice over the medium-term. And it is unlikely to hit its target of 800 more GPs by 2027. Spending on general practice as a proportion of overall NHS spending has fallen slightly in recent years. And between 2021/22 and 2023/24 spending decreased by 6 per cent in real terms, putting more pressure on GP practices.

National data for primary care remains inadequate. There is a lack of robust information about general practice demand, workload, workforce, and quality of care. This limits the Scottish Government’s ability to say whether the GMS contract changes represent value for money or have improved patient care.

Stephen Boyle, Auditor General for Scotland, said: “The pandemic pushed back plans for general practice. But the new delivery deadlines that were put in place were missed, and there’s not been enough transparency about progress since then.

“The Scottish Government needs to clarify its plan for general practice and set out the actions, timescales and costs to deliver it.”

Radical changes needed to deliver primary care fit for the 21st century, says Holyrood Committee

A radical revision of primary care is essential to ensure the next generation of citizens receive the care they need, according to the Scottish Parliament’s Health and Sport Committee.

In a report published today, the Committee say the traditional 9-5, 5 days a week service must become a thing of the past, replaced with a new model shaped around users’ needs. They urge the health service to fully embrace technology, enabling better data sharing and monitoring, to deliver a 21st century system fit for patients.

The Committee’s report is the culmination of a two-year inquiry into the future of primary care. The innovative inquiry was centred around members of the public with their views shaping the inquiry. The first phase of the inquiry, published in July 2019, revealed the public’s desire and support for a transformation in how services are accessed and delivered.

The inquiry has highlighted the growing costs and demands on the health service due to an ageing population and their more complex health needs, as well as an obesity epidemic and stark health inequalities in Scotland’s most deprived areas.

The Committee’s report questions the Government’s commitment to recruit at least 800 more GPs by 2030. They say the emphasis should instead be placed on committing to appropriate recruitment of professional staff across multi-disciplinary teams (MDTs), including both GPs and other professions, which can deliver the intended benefits to primary care as a whole.

Speaking as the report was published, Committee Convener Lewis Macdonald MSP said: “It is clear that when it comes to primary care the status quo is no longer an option. Existing ways of delivering care are not only financially unsustainable but have failed to keep pace with modern life.

“We need to radically rethink primary care so that we can ensure our citizens receive the best possible care for generations to come.

“We must move away from the automatic provision of prescriptions and towards social prescribing. There must be widespread adoption of a preventative model of delivering care and the health service must fully embrace new technology.

“A fundamental shift is also required in how the public and health professionals view General Practice. Instead of GPs being seen as the provider of all services, a new approach should be adopted where other health professionals, who are often better placed and equipped to help and support people can do so.

“Our inquiry has been driven by hearing directly from the public about the primary care services they want, need and require and the Committee wants to thank all who took part in our public forums and shared their views.”

The Committee say a focus on prevention needs to be prioritised and mainstreamed, but for this to be a success it goes beyond just the health service.

They identify the importance of local communities in delivering good health outcomes and say there is a clear desire amongst the public for connected communities, with spaces that give people opportunities to become active and socialise, and to connect to the local natural environment.

Widespread adoption of video consulting service ‘Near Me’ during the Covid-19 pandemic has been commended although the Committee has expressed reservations that default use could deepen health inequalities.

The report can be found here.

In sickness and in health: Holyrood seeks your views on primary care

A major new inquiry has been launched into the future of primary care in Scotland by MSPs on the Health and Sport Committee. The inquiry calls on people to outline their hopes for the next generation of care, using a specially designed survey. Continue reading In sickness and in health: Holyrood seeks your views on primary care