NEWS £10m announced for out-of-hours roll-out


The Scottish Government has announced that a total of £10 million will be made available next year to fund a National Delivery Plan to transform urgent care. This follows from the recommendations made in the Primary Care Out of Hours Review, led by Sir Lewis Ritchie.


The Delivery Plan, which will be published in the Autumn, will build on the initial testing programme which is funding eight pilot sites across Scotland to test new ways of delivering out-of-hours health services.


The Delivery Plan, which will be published in the Autumn, will build on the initial testing programme which is funding eight pilot sites across Scotland to test new ways of delivering out-of-hours health services.


These test sites, based in Highland, Grampian, Glasgow, Lanarkshire, Tayside, Lothian, Fife and Ayrshire & Arran, will be used to inform the development of a wider national strategy for urgent care out-of-hours.


Crosshouse Hospital in Kilmarnock will be the national flagship test site for the recommended Urgent Care Resource Hub model, seeing multi- disciplinary teams working in a hub to support primary care patients out of hours.


Other models being tested include


Lanarkshire hub to test new access portal. NHS Lanarkshire will test a new


model of primary care, thanks to investment from the Scottish Government’s £85 million Primary Care Fund.


The £4.5 million project will see test sites in East Kilbride and Coatbridge bring together a range of health professionals in GP surgeries to help manage patient care - such as pharmacists, practice nurses, district nurses, mental health professionals, and allied health professionals like physiotherapists, as well as third sector workers.


a GP-led out-of-hours team in Grampian, nurse led home visits in Glasgow and new pathways of care for paediatric and mental health services outside of normal working hours.


It also includes a £400,000 investment in the out-of-hours technology system, Adastra, to establish a standard system across Scotland.


Dr John McAnaw, Chair of the Scottish Pharmacy Board, said: “The announced funding is great news and is warmly welcomed. We hope the recommendations in our joint response with Community Pharmacy Scotland and the Directors of Pharmacy Scotland group will be fully included in the National Delivery Plan.


“The testing of new ways of working and trialling specific models of care that include pharmacists, will hopefully enable pharmacists to be more fully integrated into the multidisciplinary team that delivers out of hours care to the people of Scotland.


“It marks the beginning of how we implement the recommendations from the Ritchie report, and will ultimately ensure that more people can access and benefit from the knowledge and skills of those pharmacists who work in our communities across the OOH period, regardless of where and when they present.”


The aim is for patients to get the right service as quickly as possible, with more same-day services, and developing urgent care 24/7 services. These will be through face-to-face meetings, telephone consultations or web services.


The test model will also free up GP time, allowing them to give more focus to patients who require their assessment as expert medical generalists – rebalancing workloads and easing pressure on family doctors.


Aileen Bryson, Head of Policy & Practice at the RPS in Scotland, said: “The funding for specific pilots that include pharmacists is very encouraging. We have been lobbying for pharmacists to be included in the multidisciplinary team since our response to the


Wilson and Barber Review in 2012 and we recommended this again in our briefing to MSPs ahead of their debate last year on ‘Redesigning primary care for Scotland’.


“The specific pharmacy-focused test in Coatbridge is a welcome initiative as we believe this will help enable decision makers to fully consider how we make better use of the expertise and accessibility available in Scotland’s community pharmacy network. Community pharmacies across Scotland remain one of the most accessible NHS services for the public and patients and fully including them in our transformed primary care teams will benefit patients but also relieve pressures on GPs, out-of-hours services and A&E departments.”


Health Secretary Shona Robison said: “Sir Lewis Ritchie’s Review into out of hours care in our NHS has provided a blueprint, and today’s announcement of eight test sites across Scotland is the first step towards delivering on the excellent recommendations made.


“This will be followed by a £10 million National Delivery Plan later this year which will look at what we have learnt from these pilot sites and how this could feasibly be rolled out across Scotland.


“This multi-disciplinary team approach, which moves away from the traditional model of the doctor being the first point of contact for all patient care, will utilise the skills of other highly trained professionals in the NHS and ensure patients are seen by the person best able to address their needs.”


NEWS IN BRIEF


SMC APPROVES UTERINE FIBROID TREATMENT


The Scottish Medicines Consortium (SMC) has approved for use across NHS Scotland a uterine fibroid treatment that could enable some women to avoid hysterectomies.


Around 40 in every 100 women develop uterine fibroids at some time in their life. Some of the treatment options may affect fertility on a temporary or permanent basis and it is estimated that about 300,000 surgical procedures are performed annually in the EU for fibroids, including approximately 230,000 hysterectomies.


Ulipristal acetate (Esmya®) is an oral treatment that gives rapid control of bleeding, reduces anaemia and shrinks the size of fibroids compared with baseline. Taken as a once daily tablet, it is used to treat women with moderate to severe uterine fibroids.


The SMC has given approval for ulipristal acetate (Esmya®) to be taken on an intermittent basis, giving women the opportunity to choose the long term medical management of uterine fibroids and potentially avoid surgery.


The decision follows Esmya’s manufacturer, Gedeon Richter, demonstrating to the SMC the benefits of the drug and that it represents value for money for NHS Scotland.


Said Essam Hadoura, Consultant Gynaecologist, working at Victoria Hospital Fife, “This approval is an important step forward in the treatment of uterine fibroids, as many women in Scotland will now be able to take Esmya® to shrink their fibroids and reduce the bleeding, rather than having to undergo major surgery.


“This is particularly good news for those women who want children and therefore wish to avoid surgery especially major risks like hysterectomy.”


Ulipristal acetate was initially accepted in 2013 by the SMC for the pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age, limited to one treatment of three months’ duration.


SCOTTISH PHARMACIST - 49


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