Transforming Primary Care – The Shape of Things To Come

Major changes are being prescribed to the way GP practices will provide care. More than 200 additional healthcare professionals are being recruited by NHS Forth Valley to become part of new multidisciplinary teams within medical practices, ensuring that patients are directed to the right care at the right time. This includes mental health nurses, pharmacists, physiotherapists and advanced nurse practitioners who will help free up GP time to deal with more complex cases.

The new way of working is in response to some of the requirements of the new GP contract. One in four GP posts in Scotland is currently vacant and these changes are designed to share the care and workload currently being experienced by family doctors. In Forth Valley 20 pharmacists have started work in practices in Falkirk town centre and North West Stirling, and work is underway to recruit another ten pharmacy posts for Stenhousemuir, Denny and Bonnybridge. The pharmacists will undertake medicine reviews, deal with repeat prescriptions and ultimately hold clinics.

Mental health nurses have already been offering support for patients with mild to moderate mental health problems in several GP practices across Clackmannanshire and Falkirk West. They have been providing treatment for mental health problems commonly treated in a GP practice, meaning patients have ready access to professionals with specialist knowledge and skills without always having to see a doctor.  This scheme is now set to expand and more than half of the area’s medical practices will have mental health nurses in place by the end of the year.

More than 70 healthcare professionals were recently welcomed to NHS Forth Valley as part of an induction day to promote team working within GP practices.

Lesley Middlemiss, Programme Manager for Primary Care Transformation, said: “This is a really good news story. The key issue for patients is that there will be a broader range of expertise available at their local GP practice, helping with both diagnosis and the management of a wide range of conditions, medicine reviews and urgent appointments for new and existing illnesses.

“It’s a really positive move towards greater team working and making sure patients are directed to the right care at the right time. This is not about replacing GPs, who remain at the heart of primary care, but easing pressure and making sure that patients get the best help where they need it most.”

The employment of mental health nurses and pharmacists forms part of six workstreams highlighted under the Primary Care Improvement Plan. Others include the appointment of ten advanced nurse practitioners who are currently under training, advanced physiotherapists, care home support nurses and practice nurse trainees. They will join the practice nurses, district nurses, health visitors, podiatrists and physiotherapists who already work together at GP practices to provide the best level of primary care.

The Improvement Plan also brings about a major change in the way immunisations are delivered. The first step of this will see a new immunisation team deliver childhood vaccinations in a range of community facilities.  A pilot scheme in Clackmannanshire has seen children under five immunised at centres in Sauchie and Tillicoultry, an approach which is set to expand across Forth Valley.

NHS Forth Valley’s Associate Medical Director, Dr Stuart Cumming, said: “A lot of work has gone into developing the Primary Care Improvement Plan as we need to increase capacity to respond to the ever increasing demand for healthcare in our communities.

“It’s important to acknowledge the hugely valuable work that our GPs do but also to recognise that many health issues can be managed using the skills of other professionals working alongside our existing Practice teams. Developing larger and more diverse primary care teams will help provide the best possible care for local patients and I’m pleased that the initial response to our recruitment drive has been very encouraging.”

NHS Forth Valley’s Primary Care Improvement Plan is supported by additional investment from the Scottish Government to enable NHS Boards and Health and Social Care Partnerships to deliver the priorities set out in the new GP contract.

A number of information evenings and events were organised to allow local clinicians to help shape the Plan which has been jointly developed and agreed by NHS Forth Valley, the two local Health and Social Care Partnerships and the Local Medical Committee.