Primary care - public understanding and perceptions survey: analysis report

1. Background

Primary care offers the first point of contact with health services when people need additional support to maintain their health. Primary care is provided by a wide range of professionals, including nurses, general practitioners (GPs), optometrists, pharmacists, dentists, service managers, receptionists and care coordinators. Primary care is the part of the National Health Service (NHS) that the most people have interactions with, providing over 20 million consultations per year^[1]. Primary care also provides access to more specialist services (such as hospital doctors) and coordinates care for individuals over time, providing continuity and supporting access. Therefore, primary care is key to the prevention and early intervention of disease, which is needed to improve population health and address health inequity.

In recent years, the Scottish Government has been working with health boards, Health and Social Care Partnerships (HSCPs) and the Scottish General Practitioner Committee (SGPC) of the British Medical Association (BMA) and other key stakeholders to transform how primary care is delivered in communities across Scotland. These reforms are intended to ensure that people see the right professional at the right time for their condition and circumstances and that highly skilled staff are deployed appropriately. Key features of primary care reform include:

• An expansion of the workforce to include more health care professionals in a wider range of roles in general practice working as part of a multi-disciplinary team (MDT), in addition to the traditional model of doctors and nurses. This means that patients have more opportunities to see someone other than a doctor where this is appropriate (e.g. a pharmacist who can review their medication).
• Increased numbers of staff within general practices in non-clinical roles (e.g. community link workers or welfare advisers) who advise and support people in relation to the social issues which are often the root causes of ill-health in Scotland^[2].
• Shifting public understanding of where they can access the care they need. For example, people can often get all the care and advice they need from a community pharmacist rather than having to see a GP. Similarly, going directly to an optometrist, dentist or physiotherapist can be a faster and more direct route for getting the right care.

In addition to these reforms, the COVID-19 pandemic has dramatically changed the way primary care has been delivered over the past two years. At the start of the pandemic in Scotland (March 2020), strict "stay at home", physical distancing and hygiene measures (cleaning, aeration, mask-wearing) were introduced. These measures were then eased and reintroduced at different rates across Scotland, depending on infection risk. These measures affected the number and type of appointments available across primary care and the way in which the public perceive and interact with services.