Health and Social Care

Vital signs that GP engagement is critical to success of integration

November 28, 2014 by Linda White No Comments | Category GPs

The new Chair of the Royal College of General Practitioners (RCGP) Scotland, Dr Miles Mack, recently signalled a far-reaching shift in thinking. ‘The metaphor of GPs as “gatekeeper” to the NHS is now outdated’ he said. ‘GPs have a central “hub” function in the NHS.’

That change is radical in itself but becomes self-evidently crucial when considering integration. GPs deal with 90% of patient contacts in the NHS. They are central to the work of Health and Social Care Integration and for it to be a success, they must be heavily involved in each and every area.

A recent poll, however, carried out among RCGP Scotland members, shone light on a worrying situation. Only half of those responding thought their local process of health and social care integration had so far been effective. We asked, ‘If GPs are being involved locally with the integration process, has this been successful?’ One respondent noted, ‘Progress locally has stalled somewhat – initially we were keen to be involved, and ready to engage, but have had to wait until top-down management structures have been put in place. We hope to pick this pace back up when local management is more clearly defined, however at present we are still awaiting the appointment of management to facilitate our involvement.’ This was representative.

In a recent meeting with the Scottish Government, it was made clear that any national support to address the situation should work at a local level. We could hardly agree more. Each practice’s and each locality’s situation and needs will be different, yet each will be asked to provide the same outcome.

April 2015 – the date when local Integration Schemes must be submitted to Ministers – is fast approaching and we must move from management set up and ‘top-down’ thinking to engagement and to the detail of delivery. We must do it sooner rather than later and ways must be found to allow GPs to be fully involved in that process. However the wheel looks from the outside, it is the hub that allows it to turn.

For more information, contact David Webster.

Comments