Remote and Rural General Practice Working Group minutes: May 2021

Attendees and apologies

Attendees and apologies:

• Dr Andrew Buist, BMA
• Dr Andrew Cowie, Deputy Chair, SGPC; GP, NHS Tayside
• Dr Charles Dunnett, GP, NHS Dumfries & Galloway
• Dr Denise McFarlane, GP, NHS Grampian
• Dr Patricia Moultrie, Deputy Chair, SGPC
• Joan Pollard, Associate AHP Director, Dumfries and Galloway
• Dr Catriona Morton, RCGP
• Pamela Dudek, Chief Exec of NHS Highland Chief Officer
• Dr Miles Mack, GP, NHS Highland
• Dr Charles Siderfin, GP, NHS Orkney; Clinical lead for SRMC
• Dr Paul Davidson, Associate Medical Director, NHS Highland

Scottish Government officials (Primary Care Division):

• David Ross, Policy Manager
• Andrew Chapman, Team Leader
• Neil Robertson, Team Leader
• Fiona Duff, Senior Primary Care Advisor
• Craig Graham, Implementation Policy Officer
• Ramsay McCall, Policy Officer

Apologies:

• Dr Alida MacGregor, RGPAS
• Ralph Roberts, Chief Executive, NHS Borders
• Joyce Robinson, Argyll and Bute, Primary Care Lead
• Naureen Ahmad, SG, Interim Deputy Director 
• Louise Bussell, Chief Officer, NHS Highland
• Dr Jonathan Ball, GP, NHS Highland 

Items and actions

Welcome and introductions

Sir Lewis Ritchie welcomed the members to the meeting.

Minutes of previous meeting 

The Group noted the previous minutes.

Covid in rural general practice

Dr Denise McFarlane provided an update on the experiences and challenges that Covid-19 has presented to rural general practice. Rural general practice experienced wide ranging changes at short notice with the introduction of many new systems and restrictions. Although they have lost the ability to have informal supportive chats amongst colleagues face-to-face, many problems can be solved remotely and moving forward this will continue. 

The Group shared similar experiences and felt the quick introduction of Covid-19 Hubs, as well as other support networks, have been an excellent help to practices. Many shared the positive news that relationships have been very good throughout the challenging time of the pandemic. However, issues in outpatient delays as a result of the lack of follow ups with patients may be increasing demand for appointments. 

Fiona Duff provided an update on behalf of Dr Alida MacGregor, RGPAS. She noted that the pandemic has impacted on practices as a result of continuing to dispense and the availability of drugs. Brexit has had an impact and as a result, practices have had to change their processes in order to get medicines to their patients.  

Sir Lewis Ritchie discussed the importance of prioritising the wellbeing of colleagues throughout Primary Care going forward, after a busy and unprecedented period of work. Pamela Dudek also discussed the importance of reflecting back to all the positives things that have arisen from Covid-19, and continuing to retain these going forward. She also discussed the priority of addressing the mental health issues arising from the pandemic and that teams and local planning will need to be set up effectively to help address the situation. 

Rural reports recommendations

Fiona Duff provided an update on the recommendations from the Rural Report published in January 2020. Progress on these recommendations has been slow due to the impact of the pandemic. The group reflected on the recommendations and discussed whether these were still the right recommendations going forward post Covid-19. Many colleagues agreed that changing the recommendations at the end of the pandemic might be the wrong thing to do. It would be important to stabilise, build and put in place what was previously planned and then review the situation. 

Pamela Dudek noted that recruitment and workforce is likely going to be the biggest challenge going forward. 

Matters arising 

Options appraisal 

Dr Andrew Buist raised the question of the GP contract implementation options appraisal and whether a deadline needed to be set for returns. 

Andrew Chapman provided an update noting that more options appraisal might come in as part of Primary Care Improvement Plan returns (which were due by the end of May 2021) and that the PCIP process was a necessary precursor of the options appraisal. 

Rural credentialing

Dr Andrew Buist raised rural credentialing and the work NES are leading on this. There were concerns that this may impact on rural general practice recruitment particularly if credentialing was to act as an obstacle. 

It was noted that this work was aimed at hospital doctors and not at rural general practice.

Closing remarks and AOB

Sir Lewis Ritchie thanked everyone for their valuable contributions and for taking the time to attend the meeting. Date of next meeting is Wednesday 22 September 2021.