NHS Recovery Plan 2021-2026: annual progress update report 2024

Primary and Community Care

Priorities for primary care remain focussed on shifting the balance of care closer to people’s homes, and driving a proactive approach of early intervention and prevention, and promoting value for money across the health system.

Working with the sector through the Primary and Community Health Steering Group, as well as with wider reforms, we are developing a Route Map for Primary Care which will set out the conditions for achieving sustainable transformation in Primary Care and shared critical priorities, over the medium- to long-term.

Progress on Delivering Commitments During 2024

Increasing the number of GPs in Scotland by at least 800 by 2027 – Scotland’s GP headcount is now sitting consistently at over 5,000, with an increase of 307 additional GPs since 2017 towards our 800 by 2027 target. A new plan to improve GP recruitment and retention was published in November this year. A key action in this plan is to retain more of our newly qualified GPs in Scotland by expanding the current fellowship offer to support early career GPs on completion of their GP training. We have also commissioned NES to work with the profession to redesign the current GP retention scheme to make it more flexible to support GPs at times in their career when it is needed. Training new GPs is also key to the approach. We have created 70 additional GP Speciality Training posts since 2022. As a result there are currently just over 1200 trainee GPs in Scotland.

Provide a wider range of common clinical conditions available for treatment through the NHS Pharmacy First service – NHS Pharmacy First is offered by all 1,258 community pharmacies across the network with approximately 400 pharmacies also offering NHS Pharmacy First Plus, where a pharmacist can use their independent prescribing qualification to treat a wider range of conditions. Data published by PHS in October 2024 showed in the financial year 2023/24, over 4.7 million Pharmacy First Scotland consultations were undertaken with 95% providing advice on self-care or treatment at the point of contact.

Treatments are available under Patient Group Directions (PGDs) for common clinical conditions such as shingles, urinary tract infections, skin conditions, impetigo and hay fever – patients and members of the public can get treatment without the need to see their GP or have a prescription. This service will continue to build on the range of conditions to be treated over the next few years.

Introduce a new pharmacy women’s health and wellbeing service – Community pharmacies provide support and treatment for a range of women’s health issues, for example cystitis, period pain and thrush as well as providing treatment under NHS Pharmacy First Scotland for specific common clinical conditions such as uncomplicated UTIs in women.

In 2024, the community pharmacy emergency hormonal contraception (EHC) and bridging contraception services were reviewed by a short life working group and updated service specifications were introduced in October 2024. The availability of EHC and bridging contraception from pharmacies enables women to access contraception without the need to visit a GP practice for a prescription.

Establish a community pharmacy hospital discharge and medicines reconciliations service – A pilot programme in NHS Greater Glasgow and Clyde has successfully demonstrated that community pharmacies can supply, reconcile, and review medicines to support hospital discharge processes. It also highlighted some of the challenges in scaling the pilot.

The Chief Pharmaceutical Officer is currently considering the final report from the pilot which includes several recommendations to progress a national community pharmacy discharge medicines supply service to enable suitable patients to leave hospital earlier.

Develop new digital solutions such as ePrescribing and eDispensing – The Digital Prescribing and Dispensing Programme (DPDP) aims to remove paper and the need for a ‘wet’ signature from the medicines prescribing and dispensing process in all areas of community prescribing and dispensing. This will mean a patient focused approach to the prescription and receipt of medicines whilst enabling processes to support GPs and transformative change to care by primary care prescribers and Community Pharmacies. Technical build of the system will start in early 2025 and planning for implementation and identification of business support services requirements is nearing completion.

Support improved NHS 24 call handling times – NHS 24 is committed to providing safe and effective care to our patients across Scotland 365 days of the year and during times of peak demand staff work hard to answer as many calls as quickly and safely as possible. NHS 24 have continued to recruit throughout the year and have exceeded their target for call handlers and clinical supervisors; overall headcount has increased steadily over the last 12 months.

In addition, NHS 24 has progressed a range of measures as part of their service optimisation work. This includes the introduction of a ‘virtual queue’, which is available to callers where wait times exceed 10 minutes. Callers are advised they are likely to wait 10 minutes and can select the ‘virtual queue’ option which does not affect the caller’s position in the queue, however, they are able to end the call and the system will automatically call them when their position in the queue is reached. Whilst this does not reduce wait time, it is a better experience for the caller and overall, just under 150,000 callers have selected this option when available.

Enhance Scottish Ambulance Service (SAS) specialist practitioner workforce – The SAS continue to work collaboratively with partners to understand better the workforce gaps in primary care and where SAS could support the delivery of sustainable services and wider reform.

Throughout 2024, the Integrated clinical hub managed 22.6% of all 999 calls, without the need to dispatch an ambulance. 158,130 patients were managed by delivering care remotely or by referral to alternative pathways of care. SAS will continue throughout the year to bolster the clinical hub, which each month prevents the dispatching of thousands of ambulances and reduces attendance at ED. In 24/25 SAS aim to fully implement Digital Prescribing for the Advanced Practitioners within the Integrated Clinical Hub to reduce unnecessary GP appointments.

The Integrated Clinical Hub is also enabling SAS to achieve their aim of increasing the number of remote clinical interventions to more than 13,000 patients per month to reduce avoidable hospital visits. In addition, SAS are aiming to strengthen their working links with local Board Flow Navigation Centres to enable direct access from the Integrated Clinical Hub and frontline staff into a broader range of pathways.

Increase patient access to NHS dental services – One year on from the introduction of dental payment reform, the latest data show the services are performing well at a national level, with almost 4 million courses of treatment delivered to patients between November 2023 and September 2024. This shows that the significant and continuing investment made in NHS dentistry is supporting high volumes of patient access to NHS care and delivering on our aims to sustain NHS dental services.

Remove NHS Dental Charges for anyone under age 26 – It remains the ambition of the Scottish Government to deliver this commitment; however, at

this time we are focusing available resources on delivery of sectoral stability and equitable dental access, including preservation of our policy commitment.

Discharge lower risk glaucoma and treated ocular hypertension patients from hospital into management of accredited community optometrists – The Community Glaucoma Service is now live in three Health Boards; NHS Greater Glasgow & Clyde, NHS Lanarkshire and NHS Dumfries & Galloway. Work is ongoing to roll out the service in the remaining Boards during the 2024/25 and 2025/26 financial years.

A National Low Vision service for visually impaired people provided by accredited community optometrists and dispensing opticians – Progress has been made in developing the infrastructure necessary for the national low vision service and it remains our ambition to roll out a community based low vision service.