We work with primary care teams to improve access to safe care
Access to General Practice has been a longstanding challenge across Scotland with increasing demand and constrained capacity. The Scottish Government has recently developed principles for access to primary care services which are:
- Access to General Practice is inclusive and equitable for people, based on the principles of Realistic Medicine and Value Based Health & Care.
- Care will be person-centred and based on what matters to the individual.
- People should have a reasonable choice about how they access services.
- Services should be approachable, sensitive, compassionate, and considerate to need.
- General Practices should help people to get the right care from the best and most appropriate person or team to care for them (Right Care, Right Place, Right Time).
General Practice access short life working group: access principles report (November 2023)
Our colleagues in Community Engagement have gathered patient and public views on these principles. They have published a report summarising key findings. Gathering views and citizens’ panel for health and social care on general practice access principles report (October 2023): They recommend that patients are involved in any changes to services and have a number of resources to support engagement and participation on their webpages.
Primary Care Access Programme
The Primary Care Access Programme (PCAP) will be delivered under the Primary Care Improvement Collaborative in Spring 2024. To find out more about the collaborative and apply to join, please visit the Join the Primary Care Improvement Collaborative webpage.
PCAP is a 7-week improvement programme which combines quality improvement (QI), demand, capacity, activity, queue (DCAQ) and sprint methods and approaches. It includes tested tools and approaches which are used at pace to provide support to primary care teams. The support is designed to help teams to use data to explore their challenges, identify areas for change and improve an aspect of access. Previous participants with examples of change ideas and the impact they made include:
- Appointments:
- A Tayside medical centre changed five urgent appointments per afternoon to routine only. As a result, the number of patients asked to call back the next day decreased from 57% to 30%.
- A Lothian medical practice changed its ratio of face-to-face to telephone appointments from 40/60 to 60/60. This increased the practice's capacity and allowed more patients to receive the most suitable appointment type for their request.
- Pharmacotherapy:
- A Lothian medical centre introduced an online review process for repeat HRT prescription requests. The time taken for each HRT review decreased from 15 minutes to 3 minutes, and the number of HRT prescriptions reviewed and re-prescribed increased threefold. In a patient survey, 89% said the new process ‘was’ or ‘may be’ an improvement on the old process.
- An Ayrshire and Arran medical practice created a new procedure to manage antidepressant prescription requests. The number of total acute prescription requests received by the practice decreased from 50-60 per day to an average of 28 requests per day.
Read our evaluation report for Cohorts 1- 3 of the PCAP. The report summarises key learning and participant feedback on the programme, and highlights the impact PCAP has on access.
Visit our Learning from Teams page to find out more about who we worked with and what they worked on.
Support for primary care teams
Participating teams receive support toexplore challenges, identify areas for change and improve an aspect of access over a 7-week programme. Primary care teams benefit from opportunities to:
- explore access challenges
- select a specific area to investigate and improve using tried and tested improvement tools
- test changes and monitor improvement, and
- share learning within clusters and further afield.
Get in touch
Email us at his.pcpteam@nhs.scot if you have a question about the Primary Care Access Programme.