Scotland’s Health Secretary says the Scottish government has ‘no choice’ but to shift funding from hospital and specialist services to GPs and community health services and he hopes the extra funding for primary care will come in the draft budget unveiled before the end of the year.

Neil Gray said he believes multi-year funding to deliver reform is necessary for the NHS and third sector  to operate sustainably and achieve more.

Mr Gray was taking questions at the NHS Scotland Event conference in Glasgow, alongside the Chief Executive of NHS Scotland Caroline Lamb from an audience predominantly made of NHS staff.

They were asked: “We have been talking about shifting care to community settings for decades. When will the financial resources focus truly shift to back this up?”

Mr Gray said, while the ambition is not new, achieving it has now become essential:

“We are at the point, and you will all feel this more so than I do, where we have no choice, we must shift the balance of care and we must make sure the resource is there in community and primary care in order to do so.

“But it is the conundrum we are all aware of: how do we shift resources in a fixed budget scenario from secondary care services, that we need to sustain, to the community in order to move to that more preventative approach?”

Mr Gray added “I hope to be able to deliver [additional money for primary care] as of the next budget and I hope, electorate willing, to do so in budgets to come.”

The Cabinet Secretary said NHS reform will only succeed if the views and ideas of staff are heard:

“I want it primarily driven by those who deliver the services – we in government need to help enable people, rather than being the ones that determine changes.”

Mr Gray acknowledged that the Scottish government also needs to offer financial certainty to both NHS boards and the third sector through recurring funding rather than one year settlements.

Earlier, Caroline Lamb had admitted that the NHS in Scotland has not fully recovered from the pandemic, with activity not yet back to pre-COVID levels.

In the coming weeks, the Scottish government is to publish a new population health framework to try to address Scotland’s stalled life expectancy improvements and a service renewal framework as the NHS prepares to meet a predicted 21% increase in the level of illness over the coming 20 years.

Digital innovation

One of the main themes of the renewal plans will be greater adoption of innovation including digital technologies, with a focus on tools that reduce the administrative burden on NHS staff.

Mr Gray said the NHS in Scotland needs to be better at adopting innovation more generally, and at taking on board the ideas of people working in services.

He predicted that the introduction of the digital front door for patients and digital prescribing will be “game changing”.

Ms Lamb suggested achieving digital and system change in NHS Scotland is complex – likening it to building on a “brown field site” rather than a green one:

“We already have a very complex digital landscape across NHS Scotland, with different systems, different versions of the same system.

“That makes everything we are trying to do in terms of rollout that bit more complex.

“But that does not make it impossible.

“What we have seen is an increasing realisation across NHS Scotland that , actually,each board is just getting on and doing its own thing has not served us very well so far.”

Ms Lamb added that people with digital skills and expertise are in short supply and as a result  it would not  be possible for every board to have a full digital team. She suggested a Once for Scotland approach will help ensure everyone – clinicians and patients alike – benefits from digital innovation everywhere across Scotland.

Read more: First Minster pledges people will see GP sooner; Prehabilitation pays off for lung cancer patients; How data insights will help deliver NHS reform

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