Evaluation of New Models of Primary Care in Scotland: Highlands and Islands Case Study

Gill Hubbard, Annetta Smith, Clare Carolan, Kate Stephen, Rebecah MacGilleEathain

Research output: Book/ReportCommissioned report


Key FindingsTwenty primary care tests of change were identified across 4 health boards -NHS Highland (including Argyll and Bute), NHS Western Isles, NHS Orkney and NHS Shetland. The expected impacts of these tests of change included:i) workforce development, training and team building, ii) reduced GP and GP practice workload, iii) MDT working, iv) access to services and service development, v) patient health and wellbeing, vi) use of technology, and vii) families. By November 2017, all but 1 of these 20 projects had been implemented or were in the early stages of implementation. Barriers to early implementation related to recruitment and appointment of staff, inadequate project leadership, lack of time and competing workloads.Four projects were selected for more in-depth exploration. These were a primary and secondary care interface project;a computer-based Cognitive Behavioural Therapy (CBT) project; the Staying Well project, which involved Staying Well Advanced Nurses (SWANs) and GPs working together to manage patients with long-term conditions (LTCs), and a self-management project, which comprised a course for patients with LTCs and common mental healthproblems.The primary and secondary care interface project appeared to have been implemented with little consultation or communication with staff or patients, which was reported to have resulted in considerable disharmony. The computer-based CBT project was considered successful in managing waiting times, but there was a perception that GPs had not fully engaged with it. The Staying Well project was reported to have increased levels of trust and confidence between GPs and SWANs, with quality of care being maintained.The Self-Management project was reported to have benefits for patients but spread and sustainability was felt to be a challenge because provision relied on the drive of a single health care provider.
Original languageEnglish
PublisherScottish School of Primary Care
Number of pages102
Publication statusPublished - 30 Jan 2019


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