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Biggest change in Angus primary care provision for a generation on the way

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Health chiefs have begun to draw up a road map for what has been described as the most significant transformation in a generation in the delivery of Angus primary care services.

Alongside the pledge that the changes will bring benefits for local communities through the creation of more cluster-based provision has come an admission that Angus will not escape the “untenable” doctors’ shortage which has led to major local issues in recent years.

The new GP contract for Scotland was one of the key areas within the report presented to Angus Integration Joint Board (IJB) on delivery of general medical services.

IJB chief officer Vicky Irons described the document as “a huge step forward for the progression of primary care services”.

She said: “Angus has a strong and longstanding relationship with Angus practices through the Clinical Partnership Group and wider planning structures.

“Angus development priorities over recent years, as well as the innovative service developments to aid the sustainability of Brechin Health Centre, have positioned us well for the implementation of the new contract.

“Examples of this would include enhanced community support, development of the advanced nurse practitioner roles within medicine for the elderly and general practice as well as the first point of access physiotherapy service within Brechin Health Centre.

“However, the significant challenge the contract places on Angus Health and Social Care Partnership and NHS Tayside cannot be underestimated.”

The report adds: “There will be an increasing need to provide workplaces within local communities to perform work previously done within practices.

“With limited capital funding we will need to make the best use of those premises we have, consider where it is practical to use space within practices, and consider where new buildings are needed. It is important to realise that premises will not be replaced on a like for like basis.”

Specific examples within the IJB report of the type of changes Angus could see include a hub model for the village of Letham and a new Brechin health centre approach to  musculoskeletal workload – 85% of which studies have shown can be seen safely and effectively by a physiotherapist without the need for a GP referral.

Tayside GP sub-committee general secretary Dr Andrew Thomson, said: “This is a roadmap to delivering a complete and fundamental change to how we deliver primary care services.

“We need to all work very much together to move successfully over what is a challenging timescale.”

Recent warnings from the British Medical Assocation that doctors are being “pushed to the brink” were also borne out by a statistic presented by Dr Thomson that as many as 40% of the country’s GPs say they intend to retire in the next five years.

Dr Thomson said Angus was already “leading the way” in Tayside with changes which will see doctors increasingly working together in clusters for local communities.

“The landscape is untenable. GPs are a limited resource and we need to use them in the best way possible,” he said.