An inquiry into alternative routes from the traditional way Scottish patients access primary healthcare services by a Scottish parliament committee has found several obstacles in the way of its expansion.

The Health, Social Care and Sport Committees called for the Scottish government to work alongside GP practices, the Royal College of General Practitioners and other primary care practitioners to create a public information campaign to better advertise the use of alternative pathways.

During its inquiry, experts told the health committee that communicating changes to primary care to the public has been an “abysmal failure” and poor awareness of these changes risks increasing health inequalities. Public awareness of primary care reform was found to be lacking, which is causing people to have lesser understanding of how and why traditional practice is changing according to the committee’s report.

Many people who participated in the committee’s public survey were not pleased with being referred to a non-GP health practitioner instead of a GP as they felt they were being pushed aside to practitioners with less experience and training.

Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said:

“While we welcome previous Scottish government public information campaigns, more must be done to increase the general public's understanding of primary care reform and its benefits, and to improve access to up-to-date information about local community health and wellbeing services.”

Alternative pathways to primary care consist of receiving care from health practitioners other than GPs, either within the GP practice or community, such as pharmacists, optometrists, audiologists, or through social prescribing. 

Social prescribing enables patients to be referred to non-clinical services. During the pandemic, use of this service increased, but the committee has found that, despite positive feedback, people are now often reverting to traditional methods of contacting their GP even if social prescribing could offer quicker care. 

Committee members have also called on the Scottish government to make available self-referral routes for certain primary care services, such as NHS audiology, which are currently available privately .

Last week’s report has raised concerns that a lack of self-referral is causing unnecessary pressure on GP practices and creating a two-tiered system for those able to afford private services.

A key concern of people who spoke to the committee is capacity issues of other healthcare professionals and if they could manage an increase of referrals from both GPs and patient self-referrals.

A single patient electronic record, to enable all primary care practitioners to access patients’ data, was also a key recommendation of the committee.

Ms Martin said "GP visits must remain a part of primary care but welcomes the increase of alternative pathways available for patients.

“It’s clear from our inquiry that for primary care reform to be successful and for pressure on GP services to be reduced, there are still some barriers to accessing non-GP primary care services which must be addressed.

“Chief amongst these is the need for a single patient electronic record that would enable all primary care practitioners to access a patient’s information. We feel the need for this is more urgent than ever.”

The committee welcomed the wider rollout of link workers as a “vital” part of expanding alternative pathways but said a best practice approach must be developed.

Ms Martin said:

“Good signposting is critical in helping patients navigate these alternative pathways successfully and the pivotal role GP receptionists play in this regard needs to be properly recognised. The increasing incidences of aggressive and abusive behaviour towards receptionists is not acceptable and action must be taken to prevent this.

“It is also clear that workforce and recruitment issues are hampering greater use of alternative pathways to primary care.

“It is only once these barriers have been overcome that alternative pathways to primary care will achieve their full potential, getting quick, appropriate access to healthcare for patients, easing pressure on GP services and delivering a reformed healthcare system that is modern, flexible and community-based.”

Read more:Pharmacy: Back us as 'most accessible' health teams; GPs 'unaware' of social prescribing options; MSPs to probe alternatives to relying on GPs;