Primary Care Health Inequalities Short-Life Working Group: report

This report identifies recommendations to maximise primary care’s significant potential to tackle health inequalities and inequity across Scotland’s communities. The accompanying “Chance to Change Scotland” report also provides lived experience perspectives on the issues addressed in this report.

Annex C: Primary Care Health Inequalities Short Life Working Group: Terms of Reference


Inequalities in society are caused by a fundamental inequity in the distribution of money, resources and power. This impacts on opportunities for good-quality work, education, housing, life expectancy etc. In turn, these determinants shape individual experiences and health throughout life. Scotland has the widest of health inequalities in Western Europe - a major factor in explaining why overall levels of population health are also among the worst in Western Europe.[32] While the long-term implications of the COVID-19 pandemic on population health and health inequalities are still to be understood, it has brought a sharper focus on the importance of understanding and tackling health inequalities.

Aims of the Group

General practice, and the wider primary care team, by virtue of being embedded within communities and at the 'frontline' of the NHS, can play a pivotal role in mitigating the effects of health inequalities at a number of levels: through clinical care; wider patient advocacy; community engagement; and influencing the wider health agenda. The aim of the Primary Care Health Inequalities Short-life Working Group (SLWG) is therefore to support service improvement activity within primary and community care. In doing so, it will play a role in delivering action that will help to reduce health inequalities, improve health equity, and increase healthy life expectancy in future. The group's focus will be to identify and recommend clear actions that enable positive change that can be implemented, building on existing learning and evidence.

Terms of Reference

The group will:

1. Play an influential and leadership role on Health Inequalities within a Primary Care setting

2. Consider how to maximise existing levers within the system to address health inequalities (what does 'good look like' (including for general practice, Clusters, PCIPs)

3. Agree the metrics that are needed to guide change and monitor improvement – thinking beyond health measures where necessary

4. Consider opportunities for closer partnership working between public health and general practice as well as the third and community sectors.

5. Consider the opportunities of shifting to a model of care that has greater emphasis on digital options (such as telephone and video consultations) and consider how to mitigate against digital exclusion

6. Assess how resource can best be targeted according to the needs of local populations (adjusted for deprivation) to achieve health equity, including the establishment of a new dedicated deprivation fund with clear inclusion criteria and robust governance.


Group membership will include representation from:

External Stakeholders

Lorna Kelly – Interim Director of Primary Care NHS Greater Glasgow & Clyde and Professional Adviser Scottish Government Primary Care Directorate – Chair

Amjad Khan – NHS Education for Scotland

Amy Dalrymple- Royal College of Nursing

Andrew Buist - British Medical Association

Anne Crandles- Edinburgh Community Link Worker Programme, NHS Lothian

Belinda Robertson – Healthcare Improvement Scotland

Catriona Morton – Royal College of General Practitioners

Claire Stevens – Voluntary Health Scotland

Carey Lunan – Royal College of General Practitioners

David Blane – Clinical Research Fellow, University of Glasgow

Elspeth Russell – Head of Health Improvement, NHS Lanarkshire

John O'Dowd – Clinical Director, NHS Greater Glasgow & Clyde

Kate Burton – Public Health Practitioner, NHS Lanarkshire

Paula Spiers – NHS 24

Peter Cawston – General Practitioner, Drumchapel

Rebecca Helliwell – Primary Care Lead with Rural Focus

Roisin Hurst – Voluntary Health Scotland

Sarah Doyle – Queen's Nursing Institute Scotland

Sian Tucker – General Practitioner, Out of Hours Focus

Suzanne Glennie – Glasgow Community Link Worker Programme

Scottish Government

Alex Bowerman – Programme Advisor, Dentistry and Optometry

Jan Beattie – AHP Professional Adviser for Primary Care

Caitlin Byrne – Policy Officer, General Practice Sustainability

Katrina Cowie – Senior Policy Officer, General Practice Sustainability

Morris Fraser – Head of Substance Misuse Unit

Craig Graham – Policy Officer, General Practice Policy and Contract

Natalie Hakeem – Graduate Development Programme Member

Justin Hayes – Policy Officer, Finance, Data and Digital

Khalida Hussain – Challenge Fund Manager

Asif Ishaq – Policy Adviser, Health Improvement

Kathy Kenmuir – Professional Nurse Adviser for Primary Care

Sophie Lawson – Research Officer, Care Research

Fiona MacDonald – Principal Research Officer, Health and Social Care

Lynn MacMillan – Head of Health Inequalities Unit

Karen MacNee – Deputy Director, Head of Health Improvement

David McCaig – Head of General Practice Sustainability

Tim Mcdonnell – Director, Primary Care

Naureen Ahmad – Interim Deputy Director, General Practice Policy Division

Leslie Smith – Senior Administrator, General Practice Sustainability

Members will be expected to actively contribute between and during meetings and should be in a position to recommend and implement actions on behalf of their organisation / the sector they represent. They should also be able and willing to commit resource to develop papers and lead on agenda items either personally or from within their organisations. In this respect, membership should be drawn from senior leaders.


This group has been established under the auspices of the Ministerial Recovery Group (MRG) on recovery and remobilisation. A Primary Care sub-group chaired by Aidan Grisewood (former Scottish Government Director of Primary Care) agreed that a group was required to take forward a range of actions to tackle existing inequalities.

Frequency of meetings

The frequency of meetings will be agreed at the initial meeting of the group. Meeting agenda and papers will be circulated five days prior to meetings. It is anticipated that the group will meet once a month until the end of the current parliamentary period.


The Scottish Government will provide secretariat support to the group. Minutes and actions will be circulated within one week of the meeting.



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