Improving General Practice Sustainability Group: 2019 Report

2. Context

As many elements of the recommendations, particularly relating to the Action Plan, are covered within the new GMS contract developments, it may help to outline the key developments that have taken place since the 2017 Report was published. They include:

• Publication of the 2018 Scottish General Medical Services Contract Offer sets out the distinctive new direction for general practice in Scotland which will improve access for patients, improve population health including mental health, provide financial stability for GPs, and reduce GP workload through the expansion of the primary care multidisciplinary team.
• Publication of a co-produced Memorandum of Understanding (MoU) between Scottish Government, British Medical Association, Integration Authorities and NHS Boards^[6], in November 2017, which sets out agreed principles of service redesign, key partner roles and responsibilities, the establishment of Primary Care Improvement Plans (PCIPs) and the new national and local oversight arrangements for the contract and PCIPs.
• The 2017 National Code of Practice for GP Premises sets out the Scottish Government's plan to facilitate the shift to a model which does not entail GPs providing their practice premises. Amongst other things, this included the introduction of new interest free sustainability loans for GP owned premises supported by additional £30 million investment over the next three years.
• The Information Commissioner's Office now advises that GPs and their contacting Health Boards have joint data controller processing responsibilities towards any shared elements of the GP patient record. The new contract recognises that GPs are joint data controllers along with their contracting NHS Board. In this way, GP contractors will not be exposed to liabilities beyond their control. Further detail on premises and infrastructure initiatives can be found in the good working practice and general sustainability sections of the sustainability action plan.
• The third section of the National Workforce Plan: National Health and Social Care Workforce Plan: part 3, was published on 30 April 2018, sets out the Scottish Government's approach to recruiting 800 more doctors to general practice over the next decade and supporting and retaining the existing workforce. This is supported by an additional £7.5 million investment in 2018-19 to improve GP recruitment and retention, £2 million of that will be specifically to support remote and rural initiatives to attract and retain GPs in rural communities. Improved workforce planning which considers demand on services and an ageing population as well as a workforce is key to our national approach to workforce planning.
• Scottish Ministers have also committed to a significant expansion of the multidisciplinary team, including the training of 500 advanced nurse practitioners,^[7] 250 Community Link Workers to be in place by 2021, and 1000 paramedics to work in the community. General practice will further be supported by ensuring all practices are given access to a pharmacist by the end of this parliamentary period. An additional investment of £6.9 million will be made in nursing in primary care, particularly general practice nursing, district nursing and community nursing.
• The passing of Scottish Government Budget Bill in February 2018, confirming an increase in the Primary Care Fund from £72 million in 2017-18 to £110 million in 2018-19. This includes £100 million to support implementation of the new GP contract and wider primary care reform including a new Primary Care Improvement Fund, totalling £45.750 million, allocated to Integration Authorities in 2018-19 to fund delivery of the MOU service redesign priorities set out in local Primary Care Improvement Plans.