Scottish primary care to undergo radical review

The Scottish government should carry out a 'fundamental review' of primary care organisations, according to a financial watchdog.

Dean Marshall
Dean Marshall

A report by Audit Scotland found community health partnerships (CHPs) - subcommittees of health boards that commission primary care in Scotland - had failed to fully engage GPs. They had not managed to move care from hospitals into the community or improve quality of life for local populations, the report said.

It was 'crucial' for GPs to engage with CHPs because their clinical decisions affect NHS spending, the report said. But it warned that GPs were reluctant to become involved because they felt CHPs lacked influence.

Health trends were deteriorating under CHPs, with older people and those with long-term conditions more likely to face emergency admissions to hospital. An initial drop in delays in patients leaving hospital had now reversed, it added.

The report said that while there were examples of CHPs moving more services into the community, local initiatives were small-scale and there was 'limited evidence' of widespread sustained improvements.

GPC Scotland chairman Dr Dean Marshall said the 'highly critical' report showed that CHPs could not continue as they are. 'GPs have turned their back on CHPs because they have become bureaucratic monoliths,' he said. 'We welcome the recommendation to involve GPs in planning services for the local population and in decisions about how resources are used.'

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