Our aim is to make primary care better - April Masson

It’s well known that the NHS is under strain, especially as it continues its recovery after the Covid-19 pandemic and the yearly pressures that come with the winter months. But it’s not just frontline hospital care that is affected – Primary care services are also under strain. Providing over 620,000 consultations per week in Scotland, the long list of healthcare professionals in Scotland – GPs, nurses, physios, pharmacists and others – are also under pressure, working tirelessly to provide patients with the care they need. These professionals are acutely aware that improvements must be made to keep pace with demand now and in the future. But what are they doing about it and how are we at Healthcare Improvement Scotland helping them make vital changes that will help improve patient care?

We know that primary care services across the country, whether urban or rural, have their own unique challenges. But we also know that some themes are consistent across the country. For example, many of us are aware of the difficulty that people can face when it comes to getting appointments, regardless of whether these are same day appointments or a few weeks away. One of the ways in which we help primary care services is by helping them to look more closely at what we call care navigation. While patients might be used to seeing their GP for everything, a different healthcare professional may be more suitable to assess them or provide treatment and care. By identifying the types of help patients need early on, and making appointments with the right healthcare professionals, we can save time for doctors, admin staff and patients alike.

Another way in which we can help is by encouraging general practices to look at how they prescribe medications. Many patients will require medicines for a long period of time. Creating repeat or ‘serial’ prescriptions can be a safe and more efficient process, reducing the number of times that a patient needs to ask for prescription refills. We worked with a practice in South Ayrshire to address exactly this – we helped them to look at the types of prescriptions that were most commonly requested and they created a new system that provided appropriate reviews alongside repeat prescriptions in a safe and efficient manner. This led to a significant drop in demand on staff, allowing the practice the time it needed to make improvements elsewhere and was more convenient and sustainable for patients requiring longer term medication.

But how do we support practices to make these improvements? First and foremost, we know that primary care has incredibly limited time and people to introduce new changes, so what we offer must work in the context of their current pressures. So we focus on a short burst of targeted improvement work – we call these ‘sprints’. Practices are also incredibly well-supported by our staff – each primary care team gets an improvement coach who helps them collect the data they need, or to analyse the data already to hand, to help them decide the areas that would have the most impact. Once challenges are identified, we provide them with a number of toolkits that contain tried-and-tested approaches that we know work, which helps them make the necessary changes and improvements.

April Masson, Portfolio Lead, Primary Care Improvement Portfolio, Healthcare Improvement Scotland

From our experience, the changes that a growing number of primary care practices in Scotland are introducing, result in better access for patients, including more time with GPs for those who need it, and happier staff.

So, what next? We know from the amazing feedback we receive from primary care services that what we do truly helps. Our goal is to continue working with services across Scotland to ensure that patients continue receiving the care they need at the right time, right place and by the right professionals.

April Masson, Portfolio Lead, primary care Improvement Portfolio, Healthcare Improvement Scotland