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Health, Social Care and Sport Committee 29 March 2022

29 Mar 2022 · S6 · Health, Social Care and Sport Committee

Item of business

Alternative Pathways to Primary Care

Yousaf, Humza SNP Glasgow Pollok Watch on SPTV

Good morning to you, convener, and to the committee members. I hope that you are all keeping safe and well. I am pleased that, as one of your first inquiries, you have chosen an area often referred to as the bedrock of our health and social care services, which is, for most people, the front door to accessing the health service. I am impressed that the committee has gathered quite a diverse range of views from both primary care providers and, importantly, the wider public who use those services. It has been extremely interesting to read the feedback and the comments of contributors to the evidence sessions over the past months. As in most areas of health and social care, we have engaged in significant redesign of primary care both before and during the pandemic. It goes without saying that the contribution that primary care services make each day to the health and wellbeing of Scotland through continuity of care and meaningful relationships with patients is foundational to our public services. I thank every single member of the primary care family for their incredible efforts during the pandemic. Prior to the pandemic, we were already engaged in significant reform of pathways through the 2018 general practitioner contract. That has been a real step change in primary care pathways in the community, with people able to access a wider range of healthcare professionals through their practice while freeing up GP time to focus on more complex care. By March 2021, 2,463 staff had been recruited to the multidisciplinary teams—over two and a half whole-time equivalent staff per practice—and that number will have risen significantly over this year. For our part, we have allocated every penny of the £360 million investment committed to recruit those teams over four years, and we are delivering a further £170 million investment as part of the 2022-23 budget to continue the expansion of those important MDTs. Injecting that additional capacity into practices has been a real boon in allowing our wider primary care system to respond flexibly to the pandemic, staffing Covid hubs and assessment centres and supporting the Covid vaccination roll-out while keeping core GP services going to address the wide array of patient issues. On those core services, it is worth pointing out that, even before the pandemic, video and telephone consultations were part of how care was delivered in general practice. Over time, as restrictions ease, the balance will shift towards more face-to-face appointments—as it should—but a mixture of appointment types will remain a core part of general practice, as we know that it suits many patients to have consultations with their GP over the telephone or over video. It is not just general practice that has made significant adaptations throughout the pandemic and changed to meet the needs of its patients while keeping them safe. For example, we launched NHS Pharmacy First Scotland in the summer of 2020, which has increased the range of common clinical conditions that the community pharmacist can treat. NHS 24 has also seen a significant increase in demand over the past year as a consequence of Covid, the expansion of mental health hubs, and access through 111 to the national redesign of urgent care, all delivered 24/7, where previously NHS 24 operated largely out of hours. As we look to the horizon and to recovering from the worst of the pandemic, it is important that we continue to shape our pathways to address the demand that has arisen, and that we learn from the experience of the pandemic. As I said, GPs are usually the first port of call for people who are seeking professional help for mental health issues, and the vast majority of mental health consultations occur in primary care, covering a diverse range of needs. That is why, by the end of this session of Parliament, we will have invested in 1,000 additional mental health workers in primary care. Primary care services often deal with far more than clinical issues. That is why we are investing in providing non-clinical and social support and advice, including support for individuals who are experiencing social and financial disadvantage and exclusion. Staff such as community link workers, welfare advisers and mental health workers can help with those concerns. We are committed to a range of recommendations on tackling inequalities, following the publication of an expert group report last month. I see the focus on mental health and health inequalities as complementing and further developing the primary care reforms that we have already instigated. We will continue to commit our efforts towards having more multidisciplinary and multi-agency working, and to shifting our focus to the community to ensure that we get the right care to people at the right time. I am of course happy to take questions from the committee.

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Health, Social Care and Sport Committee 29 March 2022

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