Building a sustainable front door to primary care in Scotland

Primary care remains the backbone of Scotland’s health system, but the pressures it faces are growing each year. Rising demand, workforce shortages and long waiting times are stretching the resilience of practices across all health boards. For many staff, the constant cycle of trying to meet overwhelming patient demand risks leading to burnout. For patients, this often translates into frustration, difficulty accessing appointments and inequity of experience.

The Scottish Government has set a clear priority: health services must become more sustainable, accessible and resilient for the future. Achieving this will require not just investment in people, but the smart use of digital tools that can relieve pressure and create new capacity across primary care.

The challenge of meeting demand

General practice in Scotland plays a critical role in community health, yet practices often lack flexibility when it comes to managing patient demand. While telephony provides coverage, practices are frequently left without the agility to adapt systems quickly to local pressures. This is a significant challenge given the rise in calls and appointment requests. Patients expect timely access and choice, while staff must balance this with safe workflows and the realities of finite resources. The result is a familiar picture: long queues on the phones at peak times, patients struggling to secure appointments, and frontline teams under strain.

The role of intelligent digital navigation

To build resilience into the system, practices need smart patient navigation first to better manage demand at the first point of contact. AI-enabled digital assistants such as Surgery Assist demonstrate the impact of this approach. By acting as a patient-facing navigation tool that signposts out to local and national services, it can safely redirect or resolve up to a third of incoming requests before they ever reach the reception desk.

New features such as patient-led Appointment Booking and Online Consultation requests now take this a step further. For EMIS and TPP SystmOne users, patients can book routine appointments directly through the chatbot for services like flu jabs or smear tests, without calling the practice. Where clinical triage is needed, Surgery Assist automatically directs them to complete an Online Consultation form instead. This automation not only helps manage demand safely but also reduces waiting times and relieves administrative pressure on staff. The result is a smoother, fairer patient experience and a lighter workload for teams already operating at capacity.

For patients, this provides 24/7 access and the ability to self-serve for common needs such as booking a routine appointment, accessing Pharmacy First, or submitting a non-urgent request. For staff, it reduces pressure on phone lines and allows time to be reallocated to patients with complex needs who truly require human support. Importantly, these tools are system agnostic, meaning they can work alongside existing infrastructure and do not require costly or disruptive change.

Supporting staff and protecting the patient experience

The sustainability of primary care depends on more than simply reducing phone calls. Staff wellbeing must also be protected. Intelligent care navigation helps by filtering demand appropriately, reducing the volume of unnecessary requests, and ensuring patients reach the right service first time. This can have a direct, positive impact on staff morale. Reception teams spend less time firefighting and more time supporting patients with genuine need. Clinicians, in turn, can focus on proactive clinical care rather than administration. Over time, this shift supports a more positive working environment and helps address the challenge of GP burnout.

Turning insights into action

Digital tools also bring another benefit: data. Every patient request, whether resolved by a digital assistant or routed to a clinician, provides valuable information about demand and capacity. When visible through platforms such as the Surgery Insights dashboard where data is all in one place, practices get a real-time picture of how patients are engaging with services. For practice managers and health boards, this visibility can highlight bottlenecks, benchmark performance and inform better planning. Rather than reacting to problems once they emerge, practices can anticipate demand and allocate resources more effectively. In a devolved system like NHS Scotland, where services must respond to local health needs across urban, rural and island settings, this type of data-driven planning is critical to ensuring equitable access.

A clear pathway to sustainability

Scotland’s healthcare strategy is clear about the need to shift from analogue to digital, from hospital to community, and from reactive care to prevention. Tools such as AI-enabled patient navigation and real-time insights align directly with these goals. They help ease pressure on frontline staff, support patients to take greater control of their care, and allow health leaders to make more informed decisions. And they do so without requiring replacement of existing systems, crucial for practices constrained by long-term infrastructure contracts.

The pressures facing primary care in Scotland will not ease overnight. Demographic change, rising expectations and workforce shortages will continue to test the system. But by adopting intelligent, practical digital tools, practices can start to build resilience today while laying the foundation for tomorrow’s sustainable, patient-centred NHS.

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This article is sponsored by X-On Health Ltd.

www.x-on.co.uk