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Primary Care Transformation

Primary Care Transformation is focusing on the modernisation of primary care to deliver a safe, effective and person-centred healthcare service in line with the 2020 vision and the National Clinical Strategy.

This new approach focuses on multidisciplinary team working, to reduce pressures on services and ensure improved outcomes for patients with access to the right professional, at the right time, as near to home as possible.

To deliver these changes, we have invested £72 million into primary care services through the Primary Care Fund in 2017/18.  This includes funding to:

  • NHS Boards and Integration Authorities to test new ways of delivering primary care services, both in and out-of-hours, and support mental health services in primary care
  • Recruit 140 new pharmacists to work directly with practices and support the care of patients with long term conditions – freeing up GP time for other patients. 
  • Address issues around GP recruitment and retention through the GP Recruitment and Retention Fund to promote general practice in Scotland as a positive career chouce.
  • Develop digital services, including helping online appointment booking to improve patient access.
  • Expanding the Local Intelligence Service Team (LIST) analysts to support GP clusters in developing their local intelligence to determine the services they need to support their local community.

Primary Care Workforce

Following publication of Part One of the National Health and Social Care Workforce Plan in June 2017, work is underway on developing Part Two, which will focus on social care, and Part Three, which will focus on primary care services.  Part Three will be published following the conclusion of the new GP contract.  The Plan will set out a range of options at national, regional and local level for the recruitment and retention of GPs and the expansion of the capacity and capability of the multi-disciplinary team. This will include plans for recruitment, training and development of specific professional groups and roles.

GP Clusters   

A GP cluster is a professional grouping of GP practices represented at periodic meetings by Practice Quality Leads (PQLs) either face to face or by video conferencing depending on their circumstances. 

A Practice Quality Lead is one GP from each practice who has responsibility to link with their Cluster Quality Lead.  Under the requirements of the GP contract, they spend around two hours per month preparing practice responses to data provided by the cluster.

A Cluster Quality Lead is a GP nominated by the cluster with responsibility to provide a quality improvement leadership role to other GPs in their cluster.  The Cluster Quality Lead will liaise between practices and the NHS Board / Health and Social Care Partnership on quality improvement issues.

To carry out this work, there needs to be protected time for the GPs taking on these roles, and an infrastructure that supports leadership and assists with data provision and analysis. 

Clusters may be of different sizes, and be influenced by local circumstance and geography.  They should be a small group, consisting of between five and eight GP practices.  These clusters provide a mechanism whereby GPs may engage in peer-led quality improvement actitivty and contribute to the oversight and development of care within their healthcare system. 

To help support GP clusters, the Scottish Government’s Deputy Chief Medical Officer produced Improving Together: A National Framework for Quality and GP Clusters in Scotland in association with a number of key stakeholders who sat on the GP Cluster Advisory Group.  This Framework, published in January 2017 set out the principles and values that NHS Boards and Health and Social Care Partnerships should be considering when delivering GP services in their areas, and help GP clusters consider their role in supporting their local Boards or Partnerships.