August 2026 Update
Committee
In May we were unsuccessful in recruiting to the committee after the resignations shortly before the AGM. There remain 3 partner/salaried GP positions and the sessional position free. We need representation for general practice at a local level. As GP’s we have a collective responsibility to work to ensure both the best working conditions for our colleagues and provide ourselves with the best resource to look after our patients. This will be challenging without adequate representation and should be a serious concern to all practices.
Members of the LMC sit on the GP Subcommittee and have an opportunity to attend the Area Medical Committee. There is a continuing ask for us contribute to a wide range of other work streams from IT, governance, PCIP work streams and many others. We need people to represent our profession in these spaces. All positions are remunerated; many required a commitment of only an hour or a session every 2-3 months and all provide an opportunity to understand more about the primary secondary care interface as well as having an impact of future GP workload.
PCIP
The health board have continued with their options appraisal over the summer with work stream leads looking at how they can provide their services with less resource. By mid-September they will report back to the PCIP board with suggestions to be considered. The LMC have continued to engage with the health board team, making it clear the services provided are for patients (not GPs) and that they are obligated to provide these to patients in the 2018 contract. We are well are that the contract we were promised in 2018 is not yet delivered and not funded appropriately.
Workforce Payment
The deadline for any final updates to the workforce payment submission is the 28th August in for practices to receive the tranche 2 payments. Guidance in supporting the implementation of the workforce payment in practice has been produced by the SGPC.
Sustainable working
The SGPC have launched their ‘Sustainable Working In General Practice’ document. This highlights much of the hidden workload undertaken in general practice and begins to describe ways in which this can be measured, acknowledged and planned for. We would urge everyone to read this and consider its implementation in conjunction with utilisation of workforce payment.
Non-Staff Expenses
Applications for the non-staff expenses have to be submitted by the 28th August. At the time of writing only 1/3 of practices across the country have submitted these. SGPC and Scottish government are aware the form is not great, you can’t see the list of questions that will be asked until you go through it and similar to the workforce payment submission, it does not give you a summary at the end of what you have submitted. However, please remember to fill in and let us know of issues.
Shared Care Agreements
At the recent GP Sub meeting Shared Care Agreements were agreed for Rheumatology and Dermatology biologic agents. These are a positive step making it clear where responsibility falls for their prescribing and monitoring, with all monitoring and prescribing taking place in by secondary care. These documents will be shared by NHSB shortly with others being worked on as well as a process for any new medications requiring a shared care process to be agreed before being rolled out.
There has been recent discussion with some practices where responsibility lies for initiation of injectable therapies for type 2 diabetes, with some requests being sent to practices to initiate. Scottish Government was recently asked to adjudicate on this recently in another health board area. Their guidance was clear that:
‘It is for GPs to determine, having due regard to their clinical judgement of the patient’s needs and circumstances, what should be prescribed or what they are not competent to prescribe or what they cannot safely prescribe. If the Health Board wants to encourage GPs to prescribe specialist prescriptions, these should be arranged through Shared Care Agreements, where prescriptions are initiated by an NHS Hospital Specialist and subsequently taken over by the GP’
With this guidance from Scottish Government and no current enhanced service agreement locally, we would advise practices are entitled to decline these requests.
Pessary Insertion
A proposal for a pessary LES was presented to the health board. This exists in some areas as it is an additional service out with GMS. This was declined by the health board as funding for this could not be diverted from secondary care where these can be inserted and replaced in clinics. Practices can bear this in mind when deciding whether to train new members of staff in pessary insertion.
Vision Migration
4 practices in NHSB have now migrated to Vision. Although some of the issues relating to speed of connection with the hosted desktop that is causing major issues nationally have not yet had the same effect here, practices will notice significant disruption to their ability to provide services. Patient safety issues have been raised locally with fixes not being available in the short term for many of the problems. The migration issues are making the front page of the national press. Locally a ‘Vision project program board’ is being set up, please contact us if you wish to be involved or have issues you would like to feed into it.
Walk In Clinics
The pilot continues in Hawick. June’s data shows that across Scotland an average of 16 patients a day are being seen in each clinic. Both the BMA and RCGP continue to highlight to Scottish Government that the early findings from the pilot reflect previous findings from similar experiments in England -that they do not affect flow in other parts of the system and that this investment directly into primary care would be more effective. Scottish Government continue with their pilot, are looking to extend it both in time beyond a year and have also instructed boards to bid for other WIC’s – also instructing where they should be sited. We do not know if a second WIC in the Borders has been approved yet.
LIVE Borders Referrals
As a follow up to the last update, the LIVE Borders website has been altered to reflect that referrals can come from physio or other health care workers. We would suggest patients can be care navigated through the wellbeing service should they approach practices solely for this.
Podiatry
It was reported to us GP’s were being asked to arrange xrays on behalf of podiatrists. This was because of an issue with radiology not accepting xray requests from specialist podiatrists. This has now been resolved and you should no longer be getting these requests.
Please continue to contact with questions or suggestions and please do consider contributing to the representation – we are keen to hear from enthusiastic GPs who are interested in this great opportunity to help shape general practice in the Borders.
As a reminder the GP Role Document gives indications as to work sitting within and out with GP.
