Meeting of the Parliament 10 November 2022
I can get that data for the member. I am sure that the cabinet secretary will include it in his summing up. I know that we have increased the number of GPs working in Scotland and that, as we have said many times, Scotland has more health professionals of all kinds per head of population than the other parts of the United Kingdom.
One of the most important innovations that we have seen in primary care—and one in which I am especially interested—is the move away from a purely medical model of care. We know that many of the forces that shape a person’s health and wellbeing issues are their social and economic circumstances. That is where community link workers in general practice and other social prescribing professionals in other community settings have played such a key role. Having specialist staff who can work with an individual to get to the heart of their experiences and then identify and help them to access through the system the community support, financial help or practical guidance that they need not only benefits that individual but helps to ensure that clinical staff are free to focus on cases that require a clinical approach.
The introduction of such workers was timely, as they played a truly invaluable role within their communities during the pandemic, and demonstrated admirable ability to adapt to a rapidly developing situation. I was pleased to see acknowledgement of their work not just from the committee but from several independent research and evaluation studies. We are extremely grateful for the efforts of our community link workers during a challenging time and will continue to support their work, which forms a key part of our recovery from the pandemic.
We have developed other primary care roles to help to guide patients through that complex system. Our care navigators are absolutely key in that regard. As front-of-house staff, they are often a patient’s first encounter with primary care. In recognition of the importance of their role, we are working to upskill our care navigators and to ensure that those changes are communicated to the public through the receptionist campaign that was launched earlier this year.
As well as the more varied workforce that has been developed, there are now more diverse pathways and methods to enable people to access care and support. Telephone consultations have long been part of general practice, and the pandemic has certainly increased their use. Other changes have arisen from digital innovations that were often accelerated by the pandemic. We are working to ensure that patients have as many user-friendly options to access support as possible. Increases in funding have allowed NHS 24 to move from being a predominantly out-of-hours service to one that operates 24/7. People can access telephone support through a number of pathways, including the mental health hub, the Police Scotland pathway for people in mental health distress, the wellbeing helpline and the urgent care pathway.
An increasing number of digital pathways is available to patients. We are continuing to roll out gp.scot, which is a user-friendly website that provides practices with a consistent NHS website for patients to access up-to-date health information and which will support online prescription ordering. NHS Inform, which was established in collaboration with Public Health Scotland, has seen usage of up to 12 million site visits per month to access the up-to-date self-help advice and guidance that are on offer. That is a phenomenal resource. The experience of the pandemic increased many people’s familiarity with such digital pathways, and we are working to fill gaps in digital literacy to prevent any inequality of access.
I am mindful of the fact that not everyone will benefit equally from those changes. What for one person is a positive ability to choose the care that they feel they need might just feel to another like a confusing array of options, which might create anxiety for them or dissuade them from seeking the help that they need. We are also very aware of the need to avoid change that might unintentionally widen health inequalities.
Of course, new pathways to care and an expanded workforce have needed considerable investment. The key enabler for multidisciplinary teams has been the Scottish Government’s primary care improvement fund, which has grown continuously since its introduction in 2018. To embed the progress that has been made and to expand upon it we have increased its funding to a new record level of £170 million for the year 2022-23, which will form a minimum budgeted position that will ensure continuity of funding going forward.
The committee’s report highlighted areas in which our reform agenda has delivered improvements for patients, as well as those in which we need to continue our collective efforts. I think that all of us are realistic that this winter will bring unprecedented challenges across the whole health and care system. However, those tests should not lessen our commitment to ensure that we are doing all that we can, with the resources at our disposal, to improve health outcomes through offering patients alternative routes to the care that they need.
I welcome the debate as an opportunity for us to reaffirm our commitment to ensuring that patients and their experience sit at the heart of primary care and that primary care sits at the heart of our health system.
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