Scottish GPs’ role in routine vaccination to end

The traditional role of Scotland’s family doctors in delivering vaccinations will come to an end in April next year.

The Scottish government, doctors’ trade union the BMA, NHS boards and Scotland’s integrated health and social care partnerships have just signed a joint memorandum of understanding (MoU) recommitting them to roll out a series of changes agreed in the 2018 GP contract.

Under the contract, responsibility for a number of tasks previously led by GPs will be delivered instead by NHS boards to reduce GPs’ workloads and allow their role to evolve into being ‘expert medical generalists’ supported by a multidisciplinary team of different clinical and non-clinical staff.

The pandemic has meant the timelines for the transfer of vaccination, routine management of people’s medicines and so-called ‘community treatment and care services’ – which includes management and monitoring of chronic conditions – will all cease to be led by GPs from the 1st April 2022.

The MoU, signed last Friday, states the commitments to transition services away from general practice – an approach that is unique to Scotland out of the UK nations – remain as strong as ever:

‘The principles and values expressed in it remain undiminished, and three years on, we now have considerable learning and experience to draw on to inform this next iteration of the MoU,’ the document states; going on to say:

‘Our key aim remains expanding and enhancing multidisciplinary team working to help support the role of GPs as expert medical generalists, to improve patient outcomes.

‘We remain committed to a vision of general practice and primary care being at the heart of the healthcare system where multidisciplinary teams come together to inform, empower, and deliver services in communities.’

Early in the pandemic, then Health Secretary Jeane Freeman pushed back the deadline for the transition by one year.

Signatories to the MoU state they recognise they have a ‘considerable way to go to fully deliver the GP contract offer commitments’.

In recent months, GP practices have played a central role in delivering the covid-19 vaccination programme, particularly in smaller towns and rural communities.

Under the agreement, health boards can commission GPs to be vaccinators in remote and rural places where they are the best option for local people.

A ‘vaccination transformation programme’, overseen by the Scottish government, requires all NHS boards to set up alternative arrangements for vaccinating people of all ages.

These have included the creation of vaccination centres – many of them operating from NHS board-owned health centres – enhancing the role of maternity clinicians in supporting vaccinations for pregnant women, and broadening the role of school vaccination teams.

This week the Scottish government published first details of the flu vaccination programme for this autumn and winter stating ‘GP practices are not the preferred delivery model for vaccinations’.

Under emergency pandemic legislation, community pharmacists and dentists are now allowed to deliver vaccinations, although the decision on whether to commission their support has been left up to NHS boards.

by John Macgill

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