Could Fife hold the key to taking mounting levels of stress off our overloaded GPs?
As revealed by a Courier investigation, GPs across Fife and Tayside are often buckling under the high level of demand, with some claiming red tape is also hampering their ability to perform effectively.
Andrew Rodger, a non-executive health board member and co-chairman of Fife Health and Social Care Partnership, said an opportunity exists for the country to follow a pilot scheme.
The St Andrews Model System is based on an established Alaskan “one-stop” healthcare initiative and has been in operation since 2012.
Mr Rodger said a new model of primary health care, which builds capacity within general practice, reduces workload pressure for GPs and staff and also improves access and the quality of service to patients, could be adopted nationwide.
He has already had positive discussions about the concept with health secretary Alex Neil, fellow board members and government officials, who, he said, were interested in its potential.
“Over the last few days, general practitioners have made it quite clear they are under tremendous pressure to deliver high-quality patient care, which they feel unable to achieve under the current system,” he told The Courier.
“GP organisations claim that the only solution is to increase the number of general practitioners, although this is difficult due to problems in recruitment and attraction to the profession exacerbated by the current model of general practice.”
But he said the integration of health and social care offered “a golden opportunity” to address some of the present difficulties while maintaining general practice as the cornerstone of health service delivery.
“Other models have shown outstanding success in different parts of the world.”
The next stage was to seek several practices to test the model.
“I believe this system has the potential to make a considerable impact on Scotland ‘s health and social care services,” he said.
Mr Rodger will be raising the issue at the next NHS Fife board meeting, with a view to see “how we might accelerate this model in Fife, which I believe will benefit the whole of Scotland”.Alaska meets BuckhavenTwo years ago, Buckhaven’s Muiredge Surgery trialled the Alaskan system of general practice.
It was as a result of acknowledged issues across Scotland with getting GP appointments.
Many healthcare systems around the world face similar problems but the South Central Foundation in Alaska, offering a free community health service to Native Americans, showed great progress.
The team aimed to address all the patient’s health and wellbeing issues at one appointment.
This model was said to have transformed the patient and staff experience in Alaska, radically improving health outcomes and access to services while saving money.
Representatives visited Fife, at the invitation of the Scottish Government, and dropped in on Muiredge.
So impressed were they with the model of healthcare, the practice’s Dr Swapan Mukherjee thought some of it could be replicated.
Fife sent a team to Alaska to find out more about the NUKA scheme and the pilot was set up.
Care is provided by an integrated team, basically a one-stop healthshop involving GPs, nurses and administrative staff.
In Buckhaven’s pilot 1,400 patients were supported by a team including a case manager, practice nurse, practice assistant and GP.
Andrews Rodger of Fife health board said the model was trialled locally for six months.
“Patients received an appointment at the time of their choice, which could be the same day they called, leading to improved access to same-day appointments and reduced waiting times and cancellations.”
After the pilot, patient and staff satisfaction was shown to have increased and early results suggested positive changes in improved access and the delivery of a better service.
On average, the project GP undertook significantly less face-to-face consultations and performed more phone consultations, which let the project GP spend more time with patients who required it.Open to ideasDr John Gillies, chairman of the Royal College of General Practitioners (Scotland), said the principles behind the scheme, of prevention and holistic care, were those recognised in Scotland in a work which looked to what underpinned general practice as a whole.
He added plans for the integration of health and social care offered a great opportunity to use different models of care and for GPs, hospital doctors and social care bodies to work together better.
“Localities, comprising groups of general practices, pharmacists, social workers, nurses and wider communities, should be given the space and resources to take health and social care integration forward.
“Applying the principles of NUKA will, for some areas, be a key aspect of working differently. However, new resources will need to be found if we are to deliver more care outside hospitals and a variety of models will be needed so as to find the right one for each locality.”
A Scottish Government spokesman added that the Government was always interested to hear about new models of care, or examples of innovation, which could help deliver services in more effective ways.