Out-of-hours healthcare review proposes team approach

Healthcare hubs with teams of doctors, nurses, pharmacists and other professionals can provide urgent care when normal GP surgeries are closed, a review into out-of-hours care has proposed.

The independent Primary Care Out-of-Hours Review, chaired by Professor Sir Lewis Ritchie, also recommends health boards should be better at working together and using technology to support GPs.

Sir Lewis said he hoped the recommendations in his review could lead to consistent and continuous emergency care.

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“We must think anew about what is best for both urgent and emergency care for the people of Scotland.

“We should now move towards a seamless service, which not only meets the needs of patients, but also offers a valued working and learning environment for all those delivering health and social care services, whether that be the NHS, local authority social services or the third sector,” he said.

Health Secretary Shona Robison said the review had been set up to look at how the NHS could be more effective and sustainable.

“This whole-team, community-based care approach is the foundation on which we will transform our health system.

“This of course also relates to out-of-hours care, and as Sir Lewis outlines in his review, the future model includes multidisciplinary teams working from urgent care centres across Scotland to meet the needs of their patients,” she said.

The report is published as new research by Glasgow and Dundee Universities revealed more is spent on GP surgeries in affluent areas than in the most deprived. The research suggests the formula used to fund surgeries is flawed.

According to Robison, the new GP contract in 2017, which will focus on the whole clinical team, will help GPs in disadvantaged communities.

"We are sympathetic to the case that we need to do more to ensure GPs work in disadvantaged communities is backed up by the right levels of investment,” she said.

Third sector umbrella body the Health and Social Care Alliance (Scotland) urged the Scottish Government to ensure “a level playing field” for patients.

Chief executive Ian Welsh said: “In our view this must include models of care which can make the support people need to live well in their community more findable by enabling better access to information and the skills to develop the right knowledge and relationships. 

“The National Links Worker Programme, delivered by the ALLIANCE in partnership with the Royal College of General Practitioners (RCGP), the Scottish Association for Mental Health (SAMH) and GPs at the Deep End is already highlighting the impact that such targeted support can make.”