How will GPs' role change under the new Scottish contract?

The new Scottish GMS contract, which comes into effect in April 2018, will 'refocus' the GP role to help them become expert medical generalists in their community, the Scottish BMA has said.

GPs in Scotland will soon become ‘less involved’ with routine tasks to allow them to take on more complex work, deal with undifferentiated presentations and fulfil a leadership role, according the new GMS contract.

It says focusing on these three areas - with support from an extended multidisciplinary team - will mean GPs have more time to spend with patients who need them the most and will help them become leaders in their local community.

The shift in GP role is intended to ensure they have the space and time to tackle the growing demands facing primary care as patients live longer and live with multiple long-term conditions.

Extended multi-disciplinary teams - with practice nurses and other staff taking on broader roles - will carry out some of the work currently performed by GPs.

The BMA said the changes should make practice workload more manageable and the role of GPs as the senior clinical leader in the community will ‘lead to greater professional esteem’.

Read more
>
 How the new contract takes away the burden of premises
> How the new Scottish contract changes GP funding and pay
> Read the proposed Scottish contract deal in full

The three areas GPs will be responsible for are described in more detail below:

Undifferentiated presentations

Under the new model, GPs will focus primarily on supporting and managing people with undifferentiated presentations, especially in the context of multi-morbidity and complexity.

Patients will see other healthcare professionals as their first point of contact if they have simpler, specific complaints – for example, a person with shoulder pain may choose to see a physiotherapist as the first point of contact rather than a GP.

Complex care in the community

As workload capacity is freed up, a key part of the GP role will be leading a primary care multi-disciplinary team to deliver care to patients with multiple complex conditions, general frailty associated with age and those with requirements for complex care.

The contract says practices should proactively identify the cohort of patients who require complex care and devise an appropriate plan to ensure they receive the optimum care and support.

One of the main aims of this change is to provide care to patients with complex needs ‘at home wherever this is appropriate’, the contract document explains.

Whole system activity

The new contract will ensure all GPs have regular protected time to be able to develop as clinical leaders. They will be expected to become fully involved in assessing and developing services intended to meet the needs of their patients and local communities

From April 2018, each practice will receive resources to support one session per month for 'professional time activities' for their GPs.

As the senior clinical decision-makers and leaders, GPs will assess the overall performance of their own practice, practices within their cluster and the wider community team. They will then influence direct change within the wider health and social care system.

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