Delivering quality in primary care: progress report

2. Context

The Delivering Quality in Primary Care process began in Autumn 2009. It is recognised that the scale of the challenge across the NHS in Scotland is rapidly escalating: an increase in the proportion of the population who are living longer with multiple long-term conditions, public health imperatives including reducing health inequalities, new technologies and tight financial constraints. NHS Board Chief Executives came to the view that primary care – where 90% of NHS patient contact begins and ends – should be at the heart of meeting these challenges. Importantly, engaging with all health professionals would be key to achieving this. The vital role of primary care professionals in the planning and delivery of high quality, appropriate, sustainable care also lies at the heart of the Scottish Government's recently published consultation on proposals for integration of health and social care ^[4].

This renewed engagement was met with enthusiasm and through a planned series of regional events, welcome dialogue with primary care practitioners took place. Discussion was based around the key themes of the emerging Quality Strategy (safe, person-centred, effective care). From the constructive and enthusiastic participation there emerged three high-level messages:

• Health professionals had enthusiasm to engage and work together;
• Acknowledgment that finances were a key challenge but not insurmountable; and
• Raising and sustaining quality was the prime motivator for action.

There was a focus in the process on taking action: what were the key steps which would make the biggest difference? The output of this engagement and discussions was set out in the Delivering Quality in Primary Care (DQPC) Action Plan which was launched in August 2010 by the Cabinet Secretary.This was not a separate strategy, but articulation of the Quality Strategy for primary care. In that context the DQPC Action Plan set out the strategic direction for primary care as follows:

• Care will be increasingly integrated, provided in a joined-up way to meet the needs of the whole person;
• The people of Scotland will be increasingly empowered to play a full part in the management of their health;
• Care will be clinically effective and safe, delivered in the most appropriate way, within clear, agreed pathways; and
• Primary care will play a full part in helping the healthcare system as a whole make the best use of scarce public resources.

The actions themselves are listed at Annex B and progress on these actions are covered in section 4. The plan stressed, in addition, two overarching themes about the way in which business was to be done:

• Ensuring that primary care plays its full part in the work of the NHS; and
• Engaging with independent contractors who constitute such a large proportion of primary care practitioners as full partners in service and policy developments.

The Delivering Quality in Primary Care Steering Group was set up under the Chairmanship of Sir Lewis Ritchie in October 2010. Its principal role was to monitor and drive implementation of the national actions and recommend any new actions which would help deliver the vision. The members of the group are set out at Annex A.