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Scottish GPs to access NHS-run 'treatment rooms' for procedural tasks

GPs in Scotland will have access to prescribing and treatment room services and a chronic disease monitoring team to reduce their workload under plans being drawn up as part of the new contract.

GPC Scotland chair Dr Alan McDevitt told Pulse that the NHS would be taking over the responsibility for the staff employed in the new services with GPs having an ‘explicit role’ as senior clinical leader.

He likened it to some current district nursing teams with staff working in the practice but GPs not being responsible for issues such as sick leave or maternity cover.

It would mean many jobs currently done by GPs - including repeat prescribing, drug monitoring, routine diabetic checks and other annual reviews once part of QOF - would be done by another health professional.

The treatment room service would carry out any blood tests, dressing changes or procedural tasks requested by either secondary care or the GP themselves.

Dr McDevitt said the new way of working would free GPs to focus on complex patients, making diagnoses, and improving patient outcomes.

‘We are quite clear there are three main tasks GPs will be funded for under the contract,’ he said.

‘The first is undifferentiated illness for people who are sick but can’t see another professional or anything where there isn’t a diagnosis or a clear cause where the GP can use their expert medical generalist skills.

‘The second thing is complex care – people who have a lot wrong with them so people who have more than one thing wrong with them and they are complicated because they have multimorbidity.

‘And the third role of the GP is to be the senior clinical leader with responsibility to improve patient outcomes.’

Dr McDevitt said opinions on what exactly GPs should be doing ‘vary enormously’ among the profession and he stressed the GP would remain in control of who comes to see them.

‘We want GPs to be able to decide how best to use these services and the other staff available to them. If the GP wants to do it all themselves, they can.’

Full details of the new contract including funding arrangements are expected in November with GPs being polled on the changes after a special LMC conference in Glasgow on 1 December.


Readers' comments (10)

  • 'Alice in Wonderland'

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  • Interesting.

    I wonder who is going to fund this service and whether the return on investment would be as great as allocating the funds directly to the practice?

    I wonder who is going to staff these NHS treatment rooms and how, in the context of massive workforce shortages, this will not bid up labour market costs for the practices or worse still, pinch practice staff?

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  • Assume the buck still stops with the GP.

    The day will be filled responding to trivial queries from the promised legions of new staff!

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  • Waiting in anticipation. Sounds good lets see what happens in reality. The Scottish Government are acutely aware how much its costing them to provide a service for practices they have taken over. It will be interesting to see how much they have listened and how serious they are about stopping the decline and imminent implosion of Scottish Primary Care.

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  • The expectation is that the service will underestimate the magnitude of the problem - a running theme when people take work away from GPs. That means that the service will fill up fairly quickly and the workload will pass back to the GP.

    I hope I am wrong.

    I do however applaud them for at least trying something new/ different. I agree with 4.29 that they should really split places in to 2 groups and have a control group where the equivalent funding is sent directly to practices.

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  • Since QOF has been shown not to improve outcomes, and is a waste, this is just further jobs for the boys and further nationalisation of GP services. I do not see the point, nor do I see how you can separate chronic disease management out from diagnosis and treatment and complex care. Each patient is a day older, things happen. By splitting up GP appointments into specialty groups and QOF teams you simple create more appointments, forcing patients to attend more often, annoying them and GPs Then everyone whines that we are too busy, demanding more and more.

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  • Sounds like a GPs job will be just looking after the ‘heart sinks’, one after another, surgery after surgery...

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  • May be a great change or total disaster all with 15 min appointments!

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  • Er, what about the army of practice employed staff doing this work already, most of it is done by nurses not GPs, looks like a salaried service to me. Presumably there will be a workload cap for the GPs, and some recompense for the lost LES funding, orherwise it will be pretty much the status quo.

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  • This is generally hopeful and, if it is achievable it will be a major step forward. The question is whether or not it is achievable.

    A quote from the penultimate paragraph demonstrates amajor weakness. "he stressed the GP would remain in control of who comes to see them." Everyone working in general practice knows that we have little or no control over who comes to see us. The only control we do have comes from the fact that we employ our practice nurses, phlebotomists etc. It is hard to see how the new contract will work unless we are given the power to direct patients (rather than referring them) to other services.

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