General Practice Programme Board minutes: January 2025

Attendees and apologies

Members

• Chris Black, Deputy Chair, Scottish General Practitioners Committee (SGPC)
• Nick Fayers, Chief Officer, Western Isles Health and Social Care Partnership (HSCP)
• Susan Gallacher, Deputy Director of Primary Care, Scottish Government (SG)
• Lorna Kelly, National Strategic Lead for Primary Care, Health and Social Care Scotland
• Kathy Kenmuir, Professional Adviser on Nursing, SG
• Peter MacLean, Chair of Primary Care Leads Management Group
• Tim McDonnell (Chair), Director of Primary Care, SG
• Al Miles, Deputy Chair, SGPC
• Helen Moores-Poole, Professional Adviser on Allied Health Professions, SG
• Iain Morrison, Chair, SGPC
• Robbie Pearson, Chief Executive, Healthcare Improvement Scotland (HIS)
• Stuart Reary, Professional Adviser on General Practice, SG
• Alison Strath, Chief Pharmaceutical Officer, SG
• Julie White, Chief Executive, NHS Dumfries & Galloway

In attendance

• Belinda Robertson, Associate Director of Improvement, HIS
• Amy Wilson, Director of Health Workforce, SG
• Scottish Government official
• Scottish Government official
• Scottish Government official
• Scottish Government official
• Scottish Government official

Apologies

• Brian Chittick, Chief Executive, NHS Shetland
• Roisin Kavanagh, Chair of Pharmacotherapy Strategic Implementation Group
• Pamela Stott, Chief Officer, Highland HSCP

Items and actions

Welcome and introductions

The Chair welcomed members to the first meeting of the General Practice Programme Board (GPPB) and noted that the GPPB succeeds the National GMS Oversight Group (NGMSOG). The Chair noted the draft Terms of Reference were taken as accepted, with comments received in correspondence having been actioned. The comments received on potential additions to the membership, however, would be picked up after this meeting. The minutes from the NGMSOG meeting on 8 October 2024 were accepted as an accurate record.

There was general agreement from members of this new structure and ways of working under the programme board.

General Practice Programme Board (GPPB) Programme of Work

Scottish Government official/s provided an update on the draft programme of work document for GPPB, and invited comment from the board on the template and on the workstreams listed.

In discussion the board noted:

• the importance of being able to identify from the document which groups or stakeholders would be required to contribute to delivery of workstreams and objectives
• the document should highlight progress being made, what action is required, and what is blocking progress and requires attention
• the document should be at an appropriately high level of detail, given the breadth of GPPB’s remit. This would also help GPPB to review the overall programme of work, and ensure it contributes to an agreed and consistent vision for general practice
• there should be a clear rationale for each ‘Red-Amber-Green’ status
• defining a national service specification for multi-disciplinary teams should be included within the programme of work
• it would be useful for GPPB members to have a link to a ‘live’ version

Action

Scottish Government official/s to consider the comments and provide GPPB with an updated and populated template (By April 2025)

Scottish Budget

Scottish Government official provided an update on the two additional funding streams for general practice announced in the Scottish Budget for 2025 to 2026, which relate to GP Stabilisation and Enhanced Services.

In discussion the board noted:

• the additional funding is recurring which is intended to support long term sustainability
• funding of primary medical services commissioned by NHS boards and delivered through GP practices. SG will use the performance and reform package bundle to deliver additional targeted enhanced services in general practice. This will aim to increase overall GMS investment by a further £10.5m (beyond the initial £14m) and will be determined in-year with the profession and local areas
• SG will respond to the letter from SGPC, and set out the mechanisms for the funding will be passed on to general practices
• the importance of considering the additional funding within the wider financial context – and specifically whether the percentage of the overall Health budget allocated to general practice is increasing
• the relevance of this additional funding to the recent SGPC position statement
• SGPC intends to provide advice on Local Medical Committees seeking to renegotiate the current Enhanced Services arrangements with health boards. SG officials would welcome the opportunity to discuss and review the current system with SGPC and with health board primary care leads

Action

SGPC and SG to discuss the current Enhanced Services arrangements – with input from health boards, and in the context of the additional funding stream from 2025 to 2026 (By April 2025)

Rural options appraisal

Scottish Government official provided an update on recent Options Appraisal activity, and asked the board to comment on whether changes should be considered to the Options Appraisals process and criteria.

In discussion the board noted:

• following an Options Appraisal process, which included review by the NGMSOG, the Cabinet Secretary accepted NHS Highland’s proposal for a hybrid model for vaccination delivery in Highland
• the importance of learning from the NHS Highland Options Appraisal
• interest in exploring what other circumstances – outwith remote and rural location – make local flexibility on service delivery models appropriate.
• the importance and value of local input on the best way to deliver local services
• the need for any local flexibility to be supported by clear and agreed guidance – including on when an Options Appraisal is appropriate; criteria for assessing options; and the role of national governance
• the need to ensure decisions and changes can be made in an appropriate timeframe, balancing rigour against taking action promptly
• the importance of considering how any further local flexibility might impact other parts of the Healthcare system or existing local systems
• introducing greater local flexibility would have implications for ongoing work on the Primary Care Phased Investment Programme and on baselining the Primary Care Improvement Fund

Action

Scottish Government official to assess benefits and risks of different approaches to introducing greater local flexibility for delivering General Practice services – and return to the board with an update (By April 2025).

General practitioner recruitment and retention: action plan 2024 to 2026

Scottish Government official/s introduced the item. It was noted that the action plan had involved close collaboration with the Royal College of General Practitioners and NHS Education for Scotland – but that continued input from colleagues on how to develop and strengthen the plan was important.

In discussion the board noted:

• the work on the action plan was very welcome
• it was essential that general practitioner recruitment and retention is supported by appropriate funding
• the importance of communicating the appeal and benefits of the general practitioner role to young doctors in order to support recruitment
• working with medical schools to ensure that the general practitioner role is promoted as a potential addition to the action plan
• sharing data on general practitioner recruitment and retention with health boards and HSCPs would help health boards and HSCPs with local workforce planning
• local circumstances – such as working in a remote and rural location – impacts recruitment and retention of general practitioners
• importance of considering new roles to deliver care such as GP Special Interest roles employed by Boards and working across practices and speciality settings
• the value of the national plan recognising and including what can be done at a local level

Action

Scottish Government official/s to consider the comments and keep the board updated on progress (By April 2025)

Any other business

The Chair noted an update on ongoing actions from the previous National GMS Oversight Group had been provided as a paper, and would be incorporated into the GPPB action tracker.

Action

Scottish Government official to provide an update on the National Care Service (By April 2025)

Secretariat to share the First Minister’s speech on the future of the NHS after it has been delivered on Monday 27 January 2025 (By 29 January 2025)