NHS recovery plan: progress report 2023

Primary and Community Care

Primary care is the first point of contact with the NHS for most people. This includes contact with community-based services provided by general practitioners (GPs), community nurses, dentists, dental nurses, optometrists, dispensing opticians, pharmacists and pharmacy technicians. It can also be with allied health professionals such as physiotherapists and occupational therapists, midwives and pharmacists. The actions we are taken will improve outcomes for people in primary and community care, through enhanced integrated multi-disciplinary teams, and better digital tools.

Investing in Primary Care

We are making good progress on our commitment to increasing the number of GPs in Scotland by at least 800 by 2027. Since 2017, Scotland’s GP headcount has increased by 291 to a record high of 5,209 in 2022, and there are more headcount GPs per 100,000 population in Scotland than the rest of the UK.

In 2023/24, we are providing over £2 billion to deliver and improve primary health care services in the community, enabling dental reform, provision of community pharmacy services and supporting crucial GP services through investment in multi-disciplinary teams and targeted assistance to support system sustainability. We will continue to back the crucial services that General Practices provide, supporting their work with the Primary Care Fund, and this will deliver £170 million investment in multi-disciplinary teams and enable the development and expansion of Community Treatment and Care (CTAC) services.

Effective Digital Tools

“Hospital at Home” is a targeted intervention that provides a level of acute hospital care in an individual’s own home, or homely setting that is equivalent to that provided within a hospital and plays a key role in freeing up acute hospital capacity and allows people to be treated in their own home where clinically appropriate. To support the wider programme, a digital Hospital at Home workstream has been established and workplan agreed. This is delivering:

• Digital Best Practice, to ensure teams have the right equipment and skills for mobile working
• Core Digital Systems, to ensure team members can access an appropriate electronic patient record and share data between systems.
• Remote Consultations, to embed the use of remote consultations by both phone and Near Me where appropriate for the patient and their condition.
• Remote Monitoring, to enhance patient safety and ensure timely interventions if required.

One of the responses in the pandemic aimed at accessing healthcare more safely was the greater use of online tools. As we recover from the pandemic we are committed to continuing to ensure that video-based access via the “Near Me” service a choice available for all appropriate appointments and services across health and care. To date over 2 million video consultations have taken place with an estimated saving of 64 million miles of travel. With support for Group Consultation now embedded with the application, over 9,000 group sessions have been held, with around 42,000 participants.

Work had already been well established in Scotland allowing people to be able to feed in their blood pressure from home via a locally managed SMS text service and our Remote Health Pathways Programme, “Connect Me” is building this further using a nationally procured asynchronous monitoring platform enabling access via auto telephone, on-line app or SMS. The Primary care hypertension management programme has now reached over 82,000 people with an estimated saving of over 270,000 face to face appointments. For every 50,000 people routinely monitoring their blood pressure can result in the avoidance of up to 745 Strokes and 500 heart attacks over a 5-year period. Connect Me supports several other key health conditions or services across Primary and Secondary care such as heart failure, respiratory, prostate cancer and waiting list triage.

A 'digital front door' describes a secure digital app which provides a streamlined approach to how people navigate their way through services, as well as self-manage, and access and contribute to their own health and care information. We are undertaking public engagement and consultation on a multi-channel approach for Digital Front Door by the end of this Parliament. Initial engagement is underway with key stakeholders including a citizen panel that will inform developments, including consultation requirements.

Dentistry, Optometry and Hearing Services

We have removed NHS Dental Charges for anyone aged under 26 from August 2021, and for all young people between 18 and 25 years of age, for courses of treatment started on or after 24 August 2021, NHS dental charges are to be remitted. We remain committed to increasing patient access to NHS dental services, and while NHS dental activity nationally has continued to increase since September 2022, we recognise that much more needs to be done in some areas. The implementation of a new payment reform model is underway and will both preserve the position of NHS dentistry and safeguard levels of access.

We are committed to increasing the number of patients who can be cared for at their local community optometry practice rather than in the hospital as part of a new NHS Community Glaucoma Service. Rollout of the Community Glaucoma Service has begun in some areas of NHS Greater Glasgow & Clyde, with the aim of further expansion by 2025/26.

We are further developing our community hearing services and have provided Community Hearing grant funding to the RNID (Royal National Institute for Deaf People ) ‘Near You’ pilot scheme to support local services in early detection and prevention of hearing loss, hearing aid repairs and a national directory providing information to service users.