Scotland’s health service has been urged to ‘stop talking’ about improvements to healthcare and ‘start delivering’ a 21st century system for citizens, a parliamentary inquiry has found.
The public has no interest in historical divisions between practitioners of healthcare – whether they are hospital or community based – according to a new report released by MSPs at the Scottish parliament.
A Scottish Parliament Health and Sport Committee report insists a radical revision of primary care is essential to ensure the next generation of citizens receive the care they need, and that the traditional 9-5, five-days-a-week service must become a thing of the past, replaced with a new model shaped around users’ needs.
They urge the health service to fully embrace technology, enabling better data sharing and monitoring, to deliver a 21st century system fit for patients. The Committee’s report is the culmination of a two-year inquiry into the future of primary care.
The inquiry was centred around members of the public with their views shaping the process. The first phase of the inquiry, published in July 2019, revealed the public’s desire and support for a transformation in how services are accessed and delivered.
The second part released this week, which was delayed by Covid-19, highlights the growing costs and demands on the health service due to an ageing population and their more complex health needs, as well as an obesity epidemic and stark health inequalities in Scotland’s most deprived areas.
The Committee’s report questions the Government’s commitment to recruit at least 800 more GPs by 2030. They say the emphasis should instead be placed on committing to appropriate recruitment of professional staff across multi-disciplinary teams (MDTs), including both GPs and other professions, which can deliver the intended benefits to primary care as a whole.
Committee Convener Lewis Macdonald MSP said: “It is clear that when it comes to primary care the status quo is no longer an option. Existing ways of delivering care are not only financially unsustainable but have failed to keep pace with modern life.
“We need to radically rethink primary care so that we can ensure our citizens receive the best possible care for generations to come.
“We must move away from the automatic provision of prescriptions and towards social prescribing. There must be widespread adoption of a preventative model of delivering care and the health service must fully embrace new technology.”
“A fundamental shift is also required in how the public and health professionals view General Practice. Instead of GPs being seen as the provider of all services, a new approach should be adopted where other health professionals, who are often better placed and equipped to help and support people can do so.”
He added: “Our inquiry has been driven by hearing directly from the public about the primary care services they want, need and require and the Committee wants to thank all who took part in our public forums and shared their views.”
The Committee says a focus on prevention needs to be prioritised and mainstreamed, but for this to be a success it goes beyond just the health service. It identified the importance of local communities in delivering good health outcomes and say there is a clear desire amongst the public for connected communities, with spaces that give people opportunities to become active and socialise, and to connect to the local natural environment.
Widespread adoption of video consulting service ‘Near Me’ during the Covid-19 pandemic has been commended although the Committee has expressed reservations that default use could deepen health inequalities.
A section of the report reads: “The health service must now embrace new technology, stop talking about what they are going to do and start delivering a 21st century system to patients. Historical divisions between areas, specialities and divisions must be removed, patient records shared with all health professionals. Technology should be available for use by the public, should they choose to utilise it, in as many areas as possible giving patients the opportunity to be seen and monitored remotely. The default option should always be the availability of remote monitoring. Appropriately levels of funding should be made available to enable the delivery of these services on a once for Scotland basis.”
Some of Scotland’s digital health and care institutions gave evidence to the inquiry, which found that investment in healthcare IT was way below that was needed to deliver truly innovative care.
Chaloner Chute, Chief Technology Officer, Digital Health and Care Institute, said: “We are paying for information technology support but not digital development.” The report highlighted a lack of strategic investment as a factor behind the lag in modernising IT infrastructure, with only 1-3% of the health budget being allocated for IT. In comparison, more digitally advanced countries such as Estonia and Finland spend between 5-7% of health budgets on IT.
To read the report in full visit the link here.