General Practice Access Short Life Working Group: access principles

8. Conclusion

Many General Practices across Scotland already provide a high quality of care with access delivered in line with the principles above. However, this is not every person’s experience of accessing care, and the stress, worry and anxiety that this can cause to people, families and carers can be considerable.

The Access Principles will only improve access to care for people if they are applied by General Practices, Health Boards and the Scottish Government across Scotland in a sensible and pragmatic way, ideally but not limited to, using quality improvement methodology and supported by a range of resources to make them achievable.

That said, we understand that many General Practices are under significant pressure at this time and feel that they do not have the capacity, both operationally and clinically, to significantly change the way they work. We certainly would not expect practices to do more, in the sense of providing more appointments or time with clinicians, as the welfare and wellbeing of the General Practice team is also a high priority. However, it may be helpful for practices to take cognisance of the feedback they receive from the public and make small changes to improve access, wherever that is possible within existing resources.

We would also like to reiterate again that General Practice will not be monitored or measured against the Access Principles by Health Boards as they are not quality standards. We hope that General Practices will recognise these principles in what they already do on a day-to-day basis to meet the needs of their patients. General Practices and GP Clusters should consider the principles collaboratively and learn from each other and share examples of how they have applied the principles in their practices.

We are also not suggesting that it is the responsibility of General Practice alone to apply these Access Principles to improve people’s experience of accessing care. General Practices, GP Clusters, HSCPs, Health Boards and other parts of the system can use the principles as a benchmark of what good access to all health care services should look like.

General Practices should also continue to actively seek, welcome, learn and act upon feedback (formal and informal) from people about their experience of accessing care.

We have been encouraged by the significant number of practices who, even in difficult times, have signed up to the HIS PCAP. Primary Care Access Programme - Primary Care Access Programme (ihub.scot)^[35] The experience from these practices has shown the power that small changes can make to a system or process. The support provided by the HIS Quality Improvement advisors has proven invaluable to practices to think differently about how they do things, even in challenging times. We highly recommend this programme to any General Practice which is considering making changes to their access arrangements.

Whilst acutely aware of the very significant challenges that General Practice is under at the current time, we would like to encourage all General Practices across Scotland to take this opportunity to reflect on how their patients currently access care and how they could use the principles set out in this document as best practice that we should all aspire to. Small changes can make a big difference and one of the huge strengths of general practice is its ability to adapt and change quickly and flexibly.

We would like to thank all those who kindly helped contribute to this report and we will ensure that this issue remains ‘live’ to support continuous improvement in this key area of people’s care, using the principles and structure set out in this report to underpin the future ongoing approach.

Dr Scott Jamieson - General Practitioner - Kirriemuir Medical Practice NHS Tayside

Fiona Duff - Senior Advisor - Primary Care Directorate, Scottish Government