Scottish National Users' Group (SNUG) Podcast

Dr Steve Baguley is a consultant in Sexual Health & HIV and has been Chief Clinical Digital Officer for NHS Grampian since 2010. This episode features a discussion in which he compares Estonia's effective digital health system, which requires providers to submit care summaries to a central repository, enabling seamless data sharing and full transparency for citizens (who can view their records), and Scotland's NHS, which struggles with fragmented IT systems and unfulfilled promises, failing to meet its 2017 pledge for citizen data access by 2020. There have been significant delays in GP IT Re-provisioning, electronic prescribing  and other digital transformation efforts. Steve also discusses the role of AI in healthcare. He highlights ambient scribe technology as a major breakthrough for reducing clinician administrative burden while maintaining documentation quality. However, he strongly advises caution regarding AI tools like ChatGPT for direct clinical decision-making. For critical applications, he recommends a dual-AI verification system to enhance safety and reliability. Steve argues for a pragmatic, needs-based deployment strategy for AI tools (such as ambient scribes and Microsoft Copilot), prioritizing specific use cases and user requirements. Spending time where it counts – an AI strategy for Health & Social Care in the North of Scotland 2023-27 Health and social care - data strategy: 2024 update - progress and priorities Interesting times for Scottish GP IT (Peter Cairns blog) There's only one team in Tallinn To join the NHSS Scottish Digital Health and Care Network, access Teams and use the Join Code b7tk31u. (NHS Scotland M365 account needed). You can subscribe to the SNUG podcast on the following platforms: SNUG podcast on Apple podcasts        SNUG podcast on Spotify

We have an interview this month with Dr Margaret McCartney, a Glasgow GP, broadcaster, and writer, who discusses her journey into media, the current challenges faced in general practice, and her views on technology, evidence-based medicine, and contemporary healthcare issues. Margaret shares how her media career began rather unexpectedly and gives some insights into her media engagement. She expresses significant frustration with outdated IT systems in Scottish general practice, in particular the current version of Docman, and argues for improvements and suggests integration of beneficial AI technologies could alleviate some of the administrative burdens. The conversation also covers broader healthcare themes, including the application of evidence-based medicine, highlighting the necessity for doctors to interpret guidelines flexibly, and consider patient-specific contexts and complexities. Margaret discusses the application of shared decision-making, including some situations when this may not be appropriate, the implications of fragmented healthcare teams for continuity of care, and the ethical dimensions of assisted dying, advocating caution against expanding medical powers without adequately considering vulnerable populations. Additionally, the discussion touches on concerns regarding social media's impact on young people's mental health, recommending evidence-based approaches to address negative influences effectively. Margaret McCartney Wikipedia page   MedicsVoices: Holding medicine to account The Contented Clinician podcast series BBC Radio 4 Naked Week podcast   BBC Radio 4 Inside Health Adolescence: what teen boys really think of girls, influencers and porn – Guardian Today in focus podcast Atul Gawande: Being Mortal   Frontline TV Documentary Written submission by Dr Margaret McCartney to the UK Parliament's Public Bill Committee regarding the Terminally Ill Adults (End of Life) Bill Registration and Programme for the 2025 SNUG members' day on May 29, 2025 at Westerwood Hotel

Lexacom began as a simple audio recorder program created by former GP , Dr Andrew Whiteley, originally devised to save time by sending recordings across a network to a secretary. Over two decades, the company has grown organically, serving over 60% of GPs with its digital dictation, transcription, and speech-recognition solutions. In this episode, Dr. Whiteley describes how this developed. Lexacom is now expanding its feature set beyond traditional dictation, focusing on secure cloud-hosted platforms, sophisticated speech-recognition designed for medical terms, and dynamic workflows that tailor letters, reports, and consultation notes to individual practices. A key new focus is the integration of ambient AI, which captures and processes everything said during a GP consultation, then automatically produces a structured note. This enables clinicians to focus on patients rather than data entry. Additional modes can transform dictated text into patient-friendly wording or code it into existing clinical systems. Dr. Whiteley emphasizes patient confidentiality and data security, noting that all data remains encrypted on UK-based servers. The latest version of Lexacom also offers mobile app functionality for home visits, offline work, and seamless syncing, reflecting the company's continued commitment to developing efficient, user-driven solutions for clinicians. Lexacom website Video demo of Lexacom Echo (GP Templates YouTube video) Lexacom Guide: Brief Review for General Practice (Dr Gandalf YouTube video) Star Trek Voice First Computer

In this episode, we have the privilege of speaking with Professor Roger Neighbour, former GP and past president of the Royal College of General Practitioners (RCGP). We discuss how AI-powered tools like Heidi Health and Clinitalk are providing new opportunities for GPs and GP trainees. We discuss: The impact of AI scribes on GP consultations - are they are a game-changer? The benefits and risks of increased use of AI in consultations – will this enhance clinical decisions or deskill doctors? Training implications – can AI provide useful real-time feedback to trainees? The balance between transactional (efficiency-focused) and relational (patient-focused) medicine. “There's a kind of schism developing between the transactional ways of conducting general practice and the relational ways. I can see that AI could be extremely useful in a transactional consultation to make sure that the actual clinical business got transacted efficiently and effectively …but if we have too great a reliance on that, it could potentially lead to an erosion or possibly an abandoning of some of the other human values, things like kindness, empathy, thoughtfulness, and the cultivating of a personal relationship with patients. And, if AI is sold on the basis of it will save you time, you don't need to write notes anymore, then something is at risk there…” Our conclusions? AI scribes can reduce the administrative burden, but we must ensure they do not remove the “thinking” process in consultations. AI may help reduce clinical errors and help standardize best practices but must be integrated carefully into workflows. AI tools like Clinitalk offer real-time educational feedback, helping trainees develop consultation skills. A significant risk for the future of GP consulting may be an over-reliance on AI, leading to a loss of skills like empathy, intuition, and relationship-building. BJGP Editorial: yesterday's man? (By Prof Roger Neighbour) Consulting in a Nutshell: A practical guide to successful general practice consultations before, during and beyond the MRCGP AI Scribe compared in General Practice eGPlearning YouTube video comparing  Kiwipen Tortus Anima and Heidi Health. Clinitalk Website Clinitalk: AI Empowered GP Training (Prof Anwar Khan)  WilmslowGP YouTube video Clinitalk: Demo, Security & Pricing  (Dr Nic Boeckx)  WilmslowGP YouTube video Any feedback or comments are welcome via mail: alex.defranco@phs.scot    www.snughealth.org.uk 

Dr Chris Weatherburn discusses his productive year, focusing on maintaining a work-life balance and the value of effective habits and shares insights on managing innovation responsibly within healthcare, advocating for new technology to be implemented safely. Reflecting on challenges in the GP IT landscape, he expresses confidence in overcoming uncertainties surrounding the future of the Vision system and emphasizes adaptability to change, citing the resilience and camaraderie of the GP community as key assets in navigating potential transitions. We discuss resilience, humour, and the satisfaction of patient interactions in general practice. Chris underscores the joy and impact of face-to-face consultations compared to remote methods, advocating for person-centred care despite rising pressures in Primary care. Sharing book recommendations like A Path Through the Jungle by Steve Peters, Unlock Charisma by Vanessa Van Edwards and Feel Good Productivity by Ali Abdaal, he offers insights into managing stress, maintaining curiosity, and achieving intrinsic motivation. Chris also touches on AI tools like Storm Genie and their implications for accuracy and truth in knowledge sharing. He concludes with personal reflections on avoiding news for well-being, recommending podcasts like Sliced Bread, and recounting his enjoyment of dancing! Chris Weatherburn's website Feel-Good Productivity: Ali Abdaal - Summary Unlock Charisma: Vanessa Van Edwards Cues Book Summary Storm LLM: Putting AI to the Test—Is It Accurate? Sliced Bread podcast on BBC Sounds Chris and Caroline salsa in Blackpool Storm Eowyn: Glasgow shuts down due to red weather warnings

We ponder the dramatic news that INPS has gone into administration and catch up on First Minister's questions before our main discussion with Dr Colin Brown, a retired GP and now Healthcare Informatics Consultant. Colin takes us through the evolution of GP computing systems and reflects on the challenges of implementing technology in healthcare, recounting the early adoption of Gpass, the main GP system in the 1980s and 90s. He highlights its limitations, including frequent breakdowns and outdated infrastructure, and the attempts to modernise it in the F3 group's efforts to redesign it with dual databases and a central server, which ultimately faced technical and logistical hurdles. The shift to off-the-shelf commercial systems in Scotland, the complexity of integrating systems across NHS sectors, and the overarching challenges of interoperability are key themes. In the latter part of the discussion, the potential of wearable health devices is explored, focusing on their utility for monitoring activity levels, sleep patterns, and even early disease detection. Colin highlights a German national initiative using over half a million wearable devices to gather public health data. He advocates for leveraging this type of data for predictive analytics and better clinical insights, emphasizing the need for accuracy and meaningful interpretation. The conversation also touches on the cautious adoption of AI, with specific examples like digital scribes for consultations, and raises concerns about over-reliance on technology without adequate supervision. Colin concludes by expressing optimism for modular, interoperable platforms to address these longstanding issues, stressing the importance of veracity and utility in health data. First Minister's questions from Thursday, 19/12/24 (at 46:34) from Broadcasting Scotland Everyday data for COVID-19 from mHealth devices: The PAIDUR framework by Colin Brown. How many steps a day are enough? Preliminary pedometer indices for public health The history of Gpass Inside a Santa Claus academy

In this episode, we discuss migration to the Vision system for EMIS users in Scotland, focusing on key aspects of preparation. Some advantages of the new hosted environment include automatic backups, improved access to clinical systems across multiple sites, more collaborative working, and the ability to use non-medical prescribing with barcoded scripts. Vision Anywhere provides a secure backup system, and offers offline access to patient records, and can be used for home visits. Preparatory steps for migration include the management of non-DM&D drugs, addressing unissued acute scripts, and understanding the Vision system's "Preferred Pharmacy" approach. The migration process involves a structured pre-go-live period with data validation, training, and familiarization with the Vision interface and functionality. GPs are encouraged to complete training, utilize the trial system for their practice, and familiarize themselves with system basics. Transferring methods of working can start now, as users understand how they need to use the new system, re-build data entry templates, appointments, recall and messaging systems. We speak to Dawn Ellis, one of the IT Facilitation Managers working with the NSS GP IT Re-provisioning Team, about how practices, and GPs in particular, can start to approach preparation for migration. We also hear from Dr Mark Kirk, of the Avon Practice in Lanarkshire, which is the first practice to have completed the migration from EMIS to Vision, about how he feels about the move. By accessing the NSS GP IT practice toolkit and actively engaging in available training resources, GPs can effectively adapt to the new system, ensuring improved efficiency and minimizing potential anxieties associated with this significant change. Detailed notes from this podcast discussion with Dawn Ellis NSS GP IT site   EMIS to Vision GP Practice toolkit (only accessible via SWAN) Process and preparation PPT – detailed overview of process at practice level with overview of Vision  (only accessible via SWAN) Vision 3 Quick Reference Guide for Clinicians Cegedim Learning Zone It will all be alright in the end… Any feedback or comments are welcome via email: alex.defranco@phs.scot    www.snughealth.org.uk 

Dr Beth Kerr, a GP in the Scottish Borders, discusses her involvement in digital dermatology on this month's SNUG podcast. She explains her role as a clinical lead in the development of a digital dermatology pathway in collaboration with the Centre For Sustainable Delivery (CFSD). The project is part of the Accelerated National Innovation Adoption (ANIA) Pathway  and aims to address the significant backlog in dermatology care across Scotland by implementing a streamlined process for GPs to send triage-quality images with referrals via a secure app. This app, integrated with the SCI Gateway referral system, allows images to be taken and uploaded directly to the National Digital Platform without storing data on personal devices. The project was developed in response to the increasing demand for dermatology services, with long waiting times and unfilled specialist posts posing significant challenges. The digital solution, allows GPs to easily attach images to referrals, reducing the need for patients to wait for face-to-face appointments. Beth highlighted the app's benefits, such as faster treatment, better allocation of resources, and the flexibility for GPs to use their own devices. Training resources, including videos and virtual sessions, are planned to ensure smooth adoption across Scotland. Evaluation of the project's impact will be ongoing, with regular reporting on key performance indicators to measure success and guide further development. Centre for Sustainable Delivery    Introducing the Centre for Sustainable Delivery video Developing a national Digital Dermatology Pathway  Video The Scottish Health Technologies Group's assessment of Store and Forward Teledermatology for triage of primary care referrals. Teledermatology Register for this year's SNUG conference    Traditional Scottish Ceilidh Band

In this month's episode we visit Dumfries and Galloway, the latest stop in our trip around the regions. We speak with Dr Neil Kelly, a familiar voice on the SNUG podcast, and discuss life in the South of Scotland and how things are going with preparations for GP system change, how the local project team and facilitators have become  confident in managing the change, and the importance of supporting staff during the transition.  Neil has reduced his GP leadership workload and developed a new interest in farming, but still has plenty of reflections on the evolving nature of general practice, the increase in telephone consultations, the occasional trivia of eConsult requests and why video consultations haven't taken off. We discussed some of the difficulties with integrating systems like digital dictation, ECGs, and spirometry into the new IT environment, due to budget limitations. He's impressed by Heidi Health, which shows promise in saving time through note-taking and digital dictation, and also discusses the potential benefits of Digital Dermatology, with his practice being one of the early adopters. Neil remains optimistic about the future of general practice in Scotland, contrasting it with the more corporate approach in England. He points out the positive impact of additional support staff like pharmacists, mental health nurses, and the importance of having GPs handle complex tasks. Despite fears of GPs being replaced by other practitioners, Neil believes GPs remain highly efficient and cost-effective. Listen to the end for some wine and book recommendations! Travel Scotland guide to Dumfries and Galloway Things to do in D&G Advice for beginning farmers The Wine Society The Partisan – a book review Now I'm a farmer – The Who

In this episode, we speak to Dr Hannah Allen, a GP with extensive experience in digital health and AI. She discusses her current role with Heidi Health, who developed Heidi, an AI-driven tool designed to assist clinicians. Hannah explains that her interest in Heidi was sparked by its potential to impact healthcare at scale, driven by the needs of clinicians and developed by a doctor. Heidi was originally aimed at enhancing pre-consultation processes but evolved into a comprehensive AI assistant that supports clinicians during and after consultations by automating tasks like note-taking and document generation. This evolution was influenced by a growing appetite for innovation in healthcare, especially following the COVID-19 pandemic, which highlighted the need for efficient, tech-driven solutions. Hannah details how Heidi functions in a clinical setting, describing it as a tool that transcribes consultations and automates the creation of clinical notes and other documentation. This allows clinicians to focus more on patient interactions rather than administrative tasks. She notes that Heidi is customizable, adapting to individual clinicians' preferences in how they document and manage patient care. The tool's ability to accurately transcribe and generate structured notes has been widely appreciated, with users reporting significant improvements in workflow efficiency and reduced stress. Additionally, Hannah touches on the importance of data security and compliance, explaining that Heidi adheres to GDPR and NHS standards, with robust measures in place to ensure patient data is protected. She also mentions ongoing efforts to integrate Heidi more deeply with GP systems, which would further streamline its use in clinical practice. Heidi website     Resource Centre     Medical use cases Dr. Tom Kelly, CEO & Co-founder @ Heidi introduces Heidi v2.0 USCF Grand Rounds: Generative AI in Healthcare: Is This our Hemingway Moment? Diagnosis: Teaching, Measuring, Innovating Info matters podcast: Artificial intelligence in health care: Balancing innovation with privacy Any feedback or comments are welcome via email: alex.defranco@phs.scot    www.snughealth.org.uk 

In this episode, we meet Dr Peter Cairns, who is a GP in Wester Hailes Medical Practice, in Edinburgh, and a clinical advisor to the Digital Directorate in Lothian. He mentions his involvement in the Edinburgh Community Link Network, his blog "Primary Care Crunch," and his musical hobbies. Peter discusses a currently mixed picture in general practice, highlighting some improvements in workforce pressures but also challenges like local resource issues and population growth. He reflects on the complexities of system changes in the NHS, emphasizing the need for meaningful data integration and digital transformation to improve quality in Primary Care. We hear about the experiences of practices in Lothian who have moved to the new hosted Cegedim system. Peter expresses cautious optimism about the future, with the planned move to Vision Anywhere and a variety of new plug-ins offering potential improvements in coding, data quality and workflow efficiency. He stresses the importance of high-quality Primary Care and the need for better data usage to support resource allocation and improvements in patient care. He offers a few practical tips for improving general practice, focusing on the importance of better coding, and an incremental approach by practices to their use of DACS. DataLoch Primary Care Crunch blog What's the point in worrying about Quality in Primary Care…if nobody takes the BMA Workload Guidance seriously? DACS! ATTACK! The future is (probably) digital but which ‘digital front-door' stacks up for your needs? 2023 The Royal Edinburgh Military Tattoo The First March Out Sunshine on Leith – the Proclaimers The West Lothian Question part 1 (UFO) Top 20 attractions in Lothian

In this episode, we shift our focus from GP IT Re-provisioning to another major change for practices: the upgrade from Docman 7 to the cloud-hosted Docman 10. We've previously discussed Docman's vital role in document management and the GP2GP system for records transfer. Docman is indispensable for handling the influx of results and letters we receive daily. However, like everything else, it's about to undergo an upgrade across every practice in Scotland. At our recent SNUG Members' day, Judith Milligan from National Services Scotland outlined how the initial practices were selected for the move to Docman 10 and highlighted the NSS GP IT website as a resource. Today, we hear from the One Advanced Healthcare team, who presented at the SNUG virtual members day. We'll hear from Greta Henderson, Programme Lead for Docman 10 migration; Dianne King, Head of Training and Education; John Galvin, Deployment Manager; and Paul Chenoweth, Senior Training Consultant. Paul demonstrates how Intellisense can streamline filing, using a hospital discharge letter as an example. Prepare for the transition over the next 2 years, as 900 practices in Scotland adopt Docman 10. Access to an e-learning portal and Familiarization environment will be provided shortly before a practice upgrades, but you can also visit the NSS GP IT site now (via a SWAN connection) to see a video demo of Docman 10. Subscribe to the SNUG podcast on Apple or Spotify to stay updated. OneAdvanced Document Workflow National Services Scotland GP IT page (SWAN connection)  NSS GPIT Document Management site - with Docman 10 video (SWAN connection) SNUG Virtual Members' day videos 2024 (SNUG membership needed) Changes – David Bowie Boris forgets his photo ID

In this episode, we feature a discussion with Dr. Bob Lunan, a GP from Marnock Medical Group in Kilmarnock, Ayrshire. Bob shares his journey in managing a growing patient population, expanding from 12,500 to over 18,000 patients. He discusses the challenges and successes of integrating new practices, especially during the pandemic. Bob provides insights into the implementation and evolution of the digital triage system AskMyGP. He explains how his practice adapted the system to manage patient demand effectively, balancing online and face-to-face consultations. Bob also highlights their approach to chronic disease management, emphasizing the importance of both online and in-person reviews to ensure comprehensive care. We cover the changing landscape of general practice, discussing how online consultations have shifted patient expectations and also the importance of maintaining hands-on training for new doctors. We consider the move to Vision from EMIS in Ayrshire, the anticipated challenges and some of the proactive steps practices can take to prepare. If you are interested in joining SNUG for support and resources during GP system change, please contact Alex De Franco at alex.defranco@phs.scot. Marnock Medical group AskmyGP About Kilmarnock Tripadvisor: explore Kilmarnock Biffy Clyro - Many of Horror (When We Collide)

In this episode, we meet Emma Lynas and Dr Satya Raghuvanshi, to discuss how Accurx has evolved from a clinical decision support tool for antibiotic prescribing into a comprehensive communication platform for healthcare professionals and patients, facilitating various communication needs, such as sending SMS messages, conducting remote consultations, and managing patient enquiries. It is in 98% practices in England, and has been integrated with the new Vision system for Scotland, and can be used as a tool for total triage as well as for messaging. Accurx's features include SMS messaging, structured data capture for patient consultations, and collaboration tools for healthcare teams. The platform is able to adapt to different care settings and patient preferences, offering a digital-first approach while supporting traditional communication methods. We discussed potential concerns about overwhelming healthcare practices with increased demand, how to minimise this, emphasizing Accurx's focus on supporting practices in managing their capacity effectively, and also a phased implementation approach, tailored to each practice's readiness and needs, along with the support provided by implementation and support teams. Accurx for Primary Care   Accurx on X. Accurx YouTube channel How to send a pathway to a patient How to send a Florey questionnaire to a patient Accurx: a quick summary of total triage Ivy Medical Group: How an Accurx total triage model has helped staff and patients Register for the SNUG Virtual Members' Day 2024 Any feedback or comments are welcome via email: andrew.mcelhinney2@nhs.scot or alex.defranco@phs.scot You can subscribe to the SNUG podcast on the following platforms: SNUG podcast on Apple podcasts    SNUG podcast on Google podcasts   SNUG podcast on Spotify

Welcome to 2024! Dr David Cooper, @davidcooper1975,  co-chair of SNUG and GP in Old Machar Practice in Aberdeen, discusses the progress of GPIT Re-provisioning, challenges faced, especially by EMIS practices, and the broader landscape which includes a number of upcoming projects and technological advancements expected over the next 12 months.  David hopes for efficiency savings through smarter use of IT, including DACS systems, AI, Power Automate, Microsoft Forms, and the new SharePoint environment. No new year would be complete without meeting up with Dr Chris Weatherburn, @ChrisWeatherbu1, to discuss his reading recommendations for the new year. We also, unexpectedly, tap into some of the wisdom of Arnold Schwarzenegger. Unstoppable by Dave Anderson. Dealing with changes in life is inevitable, and we have to be ready for both wins and losses. You have the power to change your own attitudes and how you respond to challenges. Chris Weatherburn review on YouTube. How to find a black cat in a dark room by Jacob Burak. Will power is a finite resource – use it wisely and focus on intention rather than outcome for personal goals and projects. Chris Weatherburn review on YouTube. Be useful – seven tools for life by Arnold Schwarzenegger. There is nothing more energizing than chasing a vision. Make sure others know about your dream and act as if it had already happened. However, rest is not just for babies and relaxation is not just for retired people! Arnold Schwarzenegger discusses origin of “Be Useful” book title on YouTube. SNUG is holding a Migrations Training Day on Wednesday 24th of April 2023 in the Westerwood Hotel Cumbernauld. Contact alex.defranco@phs.scot for more details. Microsoft Power Automate Cegedim Vision demo videos.

Could video consultations have the potential to be a game changer in medical education? In this SNUG podcast interview, Dr. Richard Darnton @DrDarnton discusses his role in running the GP part of the Medical course at the University of Cambridge, and his role as director of the GP Education Group (GPEG), focusing on the emphasis on hands-on experience for medical students in general practice. He highlights the topic of video consultations in medical education, particularly in general practice. Dr. Darnton discusses the challenges faced by GPs in adopting video consultations, including issues of complexity, logistics, and the perception of limited benefits. He suggests the use of structured video clinics in general practice, and explores the benefits of video consultations for medical education, such as overcoming space constraints and providing valuable insights into patients' environments. We discuss the experiences of students during the pandemic, where remote consultations became more prevalent. Study findings indicate that non-face-to-face consultations, including telephone and video, provide unique learning opportunities for students, improving their consultation skills and clinical reasoning. We consider the infrastructure challenges of implementing video consultations in medical education, including the need for waiting rooms, access to patient notes, and integrated consent functionalities. Dr. Darnton expresses optimism about the potential for innovative platforms to address these challenges and enhance medical education. He encourages a shift in mindset and embracing technology for the benefit of both education and clinical care. Any feedback or comments are welcome via email: andrew.mcelhinney2@nhs.scot or alex.defranco@phs.scot. Why do GPs rarely do video consultations? Qualitative study in UK general practice BJGP paper Primary care placements in the post-COVID era: A qualitative evaluation of a final year undergraduate clerkship Medical students consulting from home: A qualitative evaluation of a tool for maintaining student exposure to patients during lockdown Medical students remote consulting from home and from the health centre: A survey of prevalence and supervisor perspectives Let's face the music and dance!

GPs in England and Scotland are trying to do a broadly similar job - they both work within the NHS, yet they have different contracts, different organisational and digital infrastructures and different GP clinical systems. They both face similar challenges in terms of workload, prescribing, sustainability and increased demand. Additional team members like pharmacists, physiotherapists, mental health nurses and ANPs are reshaping the way we organise care. The digital health and social care strategies in both countries are broadly similar with a focus on digital transformation and giving patients increased access to their own records. Today we discuss all of this and more with the Digital and Tech GP Dr Gandalf @drgandalf52 who gives us some advice on meeting all of these challenges and how to use some new tech tools which can help us work more efficiently, like a new tool called Nabla co-pilot which can transcribe and summarise consultations! Don't miss it. Any feedback or comments are welcome via email: andrew.mcelhinney2@nhs.scot or alex.defranco@phs.scot. What is the NHS Spine?  The NHS app What is eGPlearning?    eGPlearning website   Youtube eGPlearning site Video consultations in General Practice SCA essential tech tips to pass Quick clinician notes in healthcare with AI by Nabla Copilot Nabla copilot website You are not a frog Agenda and Registration for November 29 SNUG Conference at Westerwood Hotel, Cumbernauld

The National Digital Platform (NDP) is an open technology platform developed by NES (NHS Education for Scotland) in collaboration with multiple partners from across health and social care. It aims to make it simpler to deliver technology that improves the care and well-being of people in Scotland. The platform brings together cloud-based digital components and services to provide technology solutions for the public sector in Scotland. It offers a range of technology services, including an identity management service, application programming interfaces (APIs), and an application development framework. In this episode, we find out more from Dr Paul Miller, who is the Clinical Informatics Lead at NHS Education for Scotland Technology Service, a working GP, and also the Co-chair of the openEHR Clinical Program Board. Paul has been a long-term member of the National Vision Users' group and Primary Care Informatics / SCIMP, before working for the NES Technology Service. We discuss the changes in general practice, the concept and development of the National Digital Platform (NDP), the electronic ReSPECT application, what the migration challenges are, the need for coexistence with commercial systems, and the importance of incremental change in transforming healthcare systems. The shift toward separating data from applications and adopting digital health platforms will be a long-term, iterative process and require strong clinical leadership. The ultimate goal is to design services around patients rather than around healthcare systems, allowing patients to access and manage their own data. Any feedback or comments are welcome via email: andrew.mcelhinney2@nhs.scot or alex.defranco@phs.scot . Paul Miller on X/Twitter: @docpaulmiller. National Digital Platform - The open technology platform for Scotland Video explainer on the Digital Platform from Digifest 2022 ReSPECT and Open EHR video from Digifest 2022 The ReSPECT process Scotland's Digital Health and Care Strategy SNUG Annual Conference and AGM November 2023

We are delighted to welcome Professor Bob Wachter in this episode of the SNUG podcast. He  is Professor and Chair of the Department of Medicine at the University of California, San Francisco (UCSF), a highly influential voice in the worlds of medicine and Health IT, renowned for his book "The Digital Doctor"and the 2016 Wachter Report on NHS digitalization. He joins us to discuss a wide range of current topics, including the future prospects for healthcare, with a particular focus on the impact of digitalization, consumer expectations, and the balance between technology and human interaction in medicine. We discuss the trends in both US and UK in terms of digitalisation, increasing demand for health care, and the impact of technology on doctor-patient interactions, as well as the rapid advancements in AI, and how healthcare delivery may be reshaped in the future. We look at issues of trust, bias, and the potential consequences of over-reliance on machines, including “automation complacency”. And finally, we explore the dynamic use of social media, particularly X/Twitter, in combating misinformation during the COVID-19 pandemic. Professor Wachter discusses his social media journey, emphasizing the role of trusted voices in providing reliable information during crises. Any feedback or comments are welcome via email: andrew.mcelhinney2@nhs.scot or alex.defranco@phs.scot You can subscribe to the SNUG podcast on the following platforms: SNUG podcast on Apple podcasts     SNUG podcast on Google podcasts    SNUG podcast on Spotify NHS Digital Academy Robert Wachter on The Digital Doctor Bob Wachter's Viral Tweet and Thoughts on AI in Medicine A Fireside Chat with Eric Topol ChatGPT: Will It Transform the World of Health Care? UCSF Department of medicine videos on Youtube In the Bubble podcast - The Doctor Can't See You Now (with Dr. Christine Sinsky) Prof Bob Wachter on X /Twitter @Bob_Wachter     SNUG on X /Twitter @SNUsersGroup

In this episode, we return to the world of Digital Asynchronous Consulting Systems (DACS) and ponder how digital changes might be implemented in general practice during a time of chaos for the NHS, as it has its 75th Anniversary. We get a fake 5-year old's opinion on DACS systems, before hearing from Michael Wong and Sandeep Singh from Engage Health Systems, who have developed a system called Engage Consult, a digital asynchronous consultation system (DACS), which is already in use in England but is new to Scotland. We covered the following ground in the conversation: Why is Engage Consult a configurable digital asynchronous consultation system (DACS) that can be tailored to meet the specific needs of healthcare practices? How is collaboration with other services facilitated? How can implementation vary based on organizational structure, such as Primary Care Networks (PCNs) in England or a more practice-level focus in Scotland? What are the automation features for intelligent routing and assignment of patient requests? What is the integration with Vision and EMIS PC? How much will the system cost? How are implementation and support approached? Video demonstrating the Engage Consult system from the SNUG Members Day 2023 (log in needed) Engage Health website Technology Enabled Care explainer on DACS systems The birth of the NHS Summertime Blues – the Who

In this episode, we delve into the fascinating world of some of the new AI tools and their impact on healthcare and innovation. We explore the advancements in large language models like ChatGPT and the potential they hold for transforming the way we access medical information and provide care. We discuss the experiences of Dr Keith Grimes, an expert in digital health and innovation, as he shares his insights from working at Babylon and his own consultancy. We unravel the main points, such as the importance of detailed instructions and questions for obtaining accurate results from language models. We touch upon the challenges and benefits associated with relying on AI for medical information, emphasizing the need for critical thinking and background understanding of medical concepts. Privacy considerations and the global access disparity in healthcare are also explored. Join us as we navigate the promises and concerns surrounding language-based tools, shedding light on their potential to revolutionize healthcare while navigating the ethical and practical considerations. Get ready to expand your knowledge and gain insights into the future of healthcare in the age of AI. Dr Gandalf and Keith Grimes discuss and demonstrate ChatGPT video: ChatGPT in healthcare UCSF debate on Chat GPT in healthcare chaired by Bob Wachter video: ChatGPT: Will It Transform the World of Health Care? The Wachter Report: Making IT Work: Harnessing the Power of Health Information Technology to Improve Care in England  GreatAIprompts.com The AI Revolution in Medicine: GPT-4 and Beyond Dr Keith Grimes contacts: www.curistica.com Linkedin: https://www.linkedin.com/in/drkeithgrimes/ Twitter: https://twitter.com/keithgrimes Register for the SNUG Member's Day May 2023

High risk medicines are defined as medicines that have a high risk of causing injury or harm if they are misused or used in error. Error rates with these medications are not necessarily higher than with any other medicines, but when problems occur, the consequences can be more significant. A number of high risk prescribing safety indicators have been identified. We talk to Dr Ann Wales, @Ann_Wales who is the Programme Director for Knowledge and Decision Support at the Digital Health & Care Innovation Centre, and she manages the National Decision Support Programme and its Right Decision Service. We also hear from Dr Scott Jamieson, @DocScott82 a GP in Tayside and member of RCGP Scottish Council, who is one of the most enthusiastic GPs in Scotland and has an interest in Quality Improvement, among many other things. He has tried out the Right Decision Support tool which alerts prescribers to potentially harmful combinations of medications, using algorithms triggered by specific conditions, patient age, and values like blood pressure and renal function. All the GPs who have tried out the tool so far want to keep it! Anyone who is a prescriber will be interested to hear more about this useful new tool, which will be made available across Scotland soon. The DQIP study Scottish Polypharmacy guidance Right Decision App library BJGP paper with high risk prescribing indicators (table 2) Sign up for new Bing powered by ChatGPT The Bing who loved me – NY Times Hard Fork podcast

How can we best measure the activity in general practice and measure how busy we really are? The In-Hours GP Activity project is a collaboration between National Services Scotland (NSS), Public Health Scotland (PHS) and the Scottish Government to access, understand and improve the availability and consistency of activity data from in-hours general practice. A pilot was held during the autumn of 2022 to try out guidance to practices on encounter recording, collect data and try out a dashboard at practice level. Numbers of “encounters” as recorded in the practice clinical systems and the corresponding “healthcare professional role” responsible for the encounter are made available as a by-product of documenting routine clinical care. Recording behaviour varies across and within practices, and to extend the project to cover all practices will require more work following feedback gained during the pilot. In this episode we have an interview with Dr Keith Moffat and Billy Davidson of NSS, who discuss the encouraging progress so far and planned next steps. We hear from our friend of the podcast, Dr Chris Weatherburn, for his annual dose of inspiration and book recommendations. This year it's all about Resilience, how to create new and sustainable habits, and being surrounded by idiots! And finally at the end of a bumper episode, we note the emergence of a new level of “smarter” AI Chat GPT (Generative Pre-Trained Transformer), which uses deep learning algorithms to analyse and generate text, with some amazing results. We discuss it rather briefly but do manage to create a poem about a famous doctor from Dundee, and a limerick about SNUG! Primary Care - In-hours General Practice Activity Visualisation Dr Chris Weatherburn video review of Resilient by Rick Hanson and Surrounded by idiots https://chrisweatherburn.com/smart-change-five-tools-to-create-new-and-sustainable-habits-in-yourself-and-others-by-art-markman/ ChatGPT  DALL-E2

Our recent SNUG annual conference on the 30th November, was held face to face for the first time in over 3 years, at the Westerwood hotel in Cumbernauld. In this episode we get a taste of the atmosphere at the conference and say hello to some of the attendees. The main focus for many people was the forthcoming GP system change, with every practice now planning a move to Vision over the couple of years. We have edited highlights of a workshop which was really useful in setting out what practices will need to think about before they embark on the task of changing systems, especially important for EMIS practices, who will have to move to a brand-new system, requiring much preparation and re-training. We hear hints and tips on what to do from Robin Cupples, and Dawn Ellis, GP IT facilitation managers with the NSS Re-provisioning team, and Dr Jim Campbell, former GP and clinical advisor to the national team. What you can do now?  Deal with your patients that are registered for patient access; register for the Cegedim elearning; find and replace any local codes; tidy up your user list; think about what third party tools you need to use; and consider data cleansing. Plan ahead for the migration period:  appointment books, data entry and Word / mailmerge templates and searches don't migrate, so those will need to be rebuilt in the new clinical system. Data validation and data mapping will be needed for the first cut of migrated data. Plan for the Read- only period: let the patients know at a suitable time; plan for how clinical notes and prescriptions issued during downtime will be recorded; consider how will you manage when lab results and screen messages are switched off (just before the final cut of your data is taken). Plan for Post migration: there will be training days and webinars. Clinical data will need to be re-entered, including allergies. And we hear from Alex De Franco, the SNUG Business Manger on how she thought the conference went. Contact the Re-provisioning team at: NSS.GPITRe-provisioniong-Scotland@nhs.scot See the latest migration news at http://gpit.scot.nhs.uk (NHS net only) Register for the Cegedim elearning Zone for videos and demos of Vision

And then there was one…. EMIS Health shared the disappointing news this week that they are unable to meet the timelines of the Scottish Framework for GP IT Re-provisioning, and as a result, have made the decision to withdraw. This will leave Vision as the only accredited GP system for Scotland. A Frequently Asked Questions (FAQ) document regarding EMIS' exit from the Framework has been created and issued to health boards. The NSS GP IT website (NHS net only) will also be updated to reflect the changes announced. If you have a specific question about EMIS, please contact your local Facilitator Lead or eHealth team, or contact the programme team at nss.gpitre-provisioning-scotland@nhs.scot. In this edition of the SNUG podcast, Drs Andrew McElhinney and Neil Kelly discuss the implications of the news for Scottish GP practices, and manage to come to a reasonably positive conclusion, while accepting that it will take a massive amount of work by boards and practices to manage a system migration for more than half of Scottish GP IT Users over the next couple of years. If you aren't already a SNUG member, see our website below for more information about SNUG, its support for GP practices in Scotland and the forthcoming November conference. https://www.snughealth.org.uk/snug-conference-and-agm-2022-november/ SNUG conference registration page Mindtools: coping with change The End by the Doors

Docman is an electronic document management system and is used by general practices across Scotland. It was integral in the move to paper light practice and provides a workflow functionality, as well as rapid transfer of discharge and clinic letters and results from hospitals via the Docman hub and electronic document transfer (EDT). Using electronic document interchange between practices, the GP2GP process has been developed to transfer patient records rapidly when they change GP practices. We hear from Sharon Wishart, who is the lead facilitator at the Primary Care Mentor team in Fife, and we discussed her experiences with Docman  over the years, as well as dealing with a recent national problem with mysteriously disappearing documents. We also have highlights from a workshop on Docman 10 at the recent SNUG Members' Day given by Sean Foster, Philp Austin and Lesley Thorpe from the supplier company, OneAdvanced, when they outlined some of the benefits of Docman 10 over Docman 7. Docman 7 relies on local servers, but Docman 10 is run on a web browser as the data is stored in the cloud. Backups and updates will be handled in the data Centre, no down time is needed by practices and speed will be consistently better even at branch sites. Remote working will be easier, as is federated working. SNUG members asked the team questions regarding coding from, documents, system speed, SCI Gateway integration, timescale for rollout, direct printing to Docman, joint folders, updating the National folder structure, and emailing documents from Docman. Oneadvanced Docman 10X Docman - Electronic Document Management for healthcare video 2011  History of Docman  National Docman Conferences 2016 highlights

Scotland's Digital health and care strategy was published in October 2021: https://www.gov.scot/publications/scotlands-digital-health-care-strategy/ What are we going to do with citizens data, with the management information that is collected, how do we address the challenges of devices and new sources of data that are coming in, how do we build trust? In this episode, we hear highlights from a plenary from the May 2022 SNUG conference given by Jonathan Cameron, Director of Digital Health and Care at the Scottish Government. There are three strategic aims: Citizens to have access to, and greater control over, their own health and care data Health and care services to be built on people-centred, safe, secure and ethical digital foundations Health and care planners, researchers and innovators to have secure access to the data they need. Jonathan explained how these aims are being taken forward, with an emphasis on how they apply to Primary Care and general practice in Scotland. Views are also sought on the new Data strategy which is out for public consultation until August 12th.   Data Strategy for health and social care Contact via email: HSCDatastrategy@gov.scot TURAS learning site: Digital Health and Care - Supporting development of a digitally skilled workforce

Professor George Crooks is the Chief Executive Officer of the Digital Health & Care Innovation Centre. He was a GP in Aberdeen for many years and understands the challenges facing Primary Care, as we move forward in a Digital age. At the recent SNUG Members' day, he gave a plenary entitled: “Back to the Future! How can we use next generation digital solutions to deliver safe effective and sustainable services?” in which he posed the following questions:  What does person centred data sharing look like? How good - and complete -  is the data that we use to make decisions for our patients and their families?  How much do we currently listen to our patients, and understand what their expectations are for the health care we provide? “All we have to do is understand that our health and wellbeing is down to us as individuals, and we have to look at better ways of empowering individuals to take more responsibility, not simply for making better health and wellbeing choices, but also delivering more of their health care themselves...” We have a condensed version of his talk on this episode – the full version with slides is available for SNUG members on our website – see link below. Your comments and queries are welcome – you can email us at alex.defranco@phs.scot Digital health & Care Innovation Centre Professor George Crooks on Twitter SNUG members Day 2022 programme and videos (for SNUG members) Back to the future theme

Dr Jamie Hartmann-Boyce is associate professor at the Nuffield Department of Primary Care Health Sciences, and her team published  a paper at the start of the Covid-19 pandemic predicting how care for patients with conditions like diabetes might worsen during national emergencies like the Covid pandemic.  She also had a paper in Diabetes care looking at the evidence that patients with diabetes were at increased risk of more severe Covid-19, and has also looked at whether Covid-19 infection may itself lead to a higher risk of developing diabetes. There is now some evidence starting to emerge that a significant number of patients with diabetes may have been lost to follow up during the pandemic, and others may now have poorer control, although there is some variation within different subgroups. We discussed what this might mean for the care of patients with diabetes, and other long term conditions, and how we might now start to address this problem. Listen to the end to hear whether e-cigarettes are a good thing, and what our favourite film trilogies are! The Centre for Evidence-Based medicine Oxford COVID-19 Evidence Service SNUG Members Day 2022 The Godfather theme song

The Practitioner Services Division of National Services Scotland (NSS) supports GP practices across Scotland in a number of important ways. In this episode, we speak to their Business Change manager Annie McDonnell (annie.mcdonnell2@nhs.scot) who describes a project to digitize new patient records coming into practices who have already backscanned their old patient records. We discussed how may practices in Scotland are participating in the project, how quality assurance works, and when the paper records may be safely destroyed. We also reflect a little on what life was like as a GP with nothing but paper patient records, and discover a film depicting life as a Highland doctor in the 1940s. Primary Care Informatics/SCIMP advice for practices on backscanning records Scottish Government Digital health and care strategy The Highland Dr film Nimrod by Elgar

We have another episode looking at the care of patients with long term conditions, today we are joined by Dr Lorenz Kemper of Medlink Solutions. This is a system for carrying out online clinical reviews and can be used for reviews of conditions like asthma and diabetes, as well as a variety of other uses like medications reviews, submitting blood pressure readings, or reviews of patients on HRT or the contraceptive pill. Lorenz discusses how Medlink started up, how it provides practices with more options for reviewing patients and can prompt an overhaul for the entire approach to review of chronic conditions.   NHS England is supporting Primary Care to move towards a Digital First approach, where patients can easily access the advice, support and treatment they need using digital and online tools. In Scotland, the Technology Enabled Care (TEC) programme is looking at a number of Remote Health pathways, including a national DACS solution. What is Medlink? video Technology Enabled health Care GP DACS updates. Barbara Fredrickson: Positive Emotions Transform Us SNUG podcast on Apple podcasts SNUG podcast on Google podcasts SNUG podcast on Spotify

Scotland's House of Care is based on the Year of Care Programme and as this BMJ article explains, is all about delivering person centred care in long term conditions. In this episode of our podcast, we discuss how we can offer Care and Support Planning to patients with long term conditions, as we speak to Dr Graham Kramer @KramerGraham and Lindsay Oliver @lindsayeoliver, two of the leading figures in promoting this approach both in England and Scotland over the past few years. We also hear from Alison Fox, the Practice Manager of St Triduana' s practice in Edinburgh, who have found that Care and support planning really works well for them, and how this has continued to be useful throughout the pandemic. Angela Coulter video: evidence for care and support planning. Cochrane Database review of evidence supporting Care and Support Planning. Many conditions, one life RCGP Person centred Toolkit Alliance video: Patient Reps from Greater Glasgow and Clyde Health and Social Care Partnership explain their experiences with the House of Care and having care and support planning conversations with health professionals. You can contact SNUG by emailing alex.defranco@phs.scot

Dr Bill Martin is a former co-chair of SNUG and has recently moved on after a long spell in general practice, during which he experienced progressive computerization of all aspects of general practice. We discussed why he still thinks general practice is a great career choice, why he thinks many of the changes which have happened during the pandemic will stick, and why we will have to be careful about “opening up” surgeries again. He reflects on impending GP systems changes, having been through it all before, and recommends lots of planning as many systems are replaced over the next few years. He decides how he might spend a billion pounds on improving GP IT in Scotland, and we discussed whether general practice might benefit from having a spin doctor at the moment! We also got on to debating whether he might want to consider running for prime minister and, of course, whether Scotland might beat Ireland at rugby? Email Alex De Franco alex.defranco@phs.scot with any comments on this or other SNUG podcasts. SNUG regional meetings BBC News article on face to face GP consultations on Scotland. Downing Street parties: How many wine bottles fit in a suitcase, and other questions Summary of The Machine Stops Read The Machine Stops here. Neil Young: Rockin' in the free world

Dr Rob Hamilton is a GP in Snug Medical Centre in Snug, a small town on the South coast of Tasmania. We say hello to Rob and hear a little about what life there is like at the moment, as the border with new South Wales is about to open and they may start to experience Covid-19 for the first time. We also reflect on a hectic 2021 with SNUG co-chair Dr Neil Kelly who gives us some ideas for new year's resolutions, including a digital detox, or at the very least, switching off notifications on your phone. And of course, we have some book reviews from Dr Chris Weatherburn, who describes SCIMP's mutation into Primary Care Informatics and gives us plenty of enthusiastic tips on maintaining positivity as the new year beckons. BMJ Talk Medicine Podcast: Wellbeing – feeling addicted to your phone? Today FM Christmas Covid Handicap Hurdle Chris Weatherburn's book reviews Positivity – Chris's Barbara Fredrickson summary Youtube video See and subscribe to Chris's newsletters here! Airplane: re-inflating the autopilot Have yourselves a merry little Christmas

Would you trust a machine to diagnose your skin cancer? Or, maybe, to reassure you that a mole is “ok”? We take a dive into the world of machine learning, which is a branch of artificial intelligence based on the idea that systems can learn from data, identify patterns and make decisions with minimal human intervention. The most promising advances in medical image analysis have used a type of algorithm known as a deep neural network. But what happens if the images aren't of good enough quality? We discuss both the great potential and also some of the current limitations of work in this area being done on both sides of the Atlantic, with Dr Colin Morton, who is a consultant dermatologist in NHS Forth Valley and is clinical operational lead for a skin cancer AI consortium in Scotland, Professor Mark Davis and Dr Dennis Murphree, the Director of Digital Health and Artificial Intelligence in Dermatology at the Mayo clinic, Rochester, Minnesota, USA. Artificial Intelligence to help diagnose skin cancers: NHS Tayside project Embracing the transformative power of digital pathology: Mayo Clinic Can we open the black box of AI? Deep learning for dermatologists Part 1  Part 2

The Scottish Digital Prescribing and Dispensing Programme, is being led by Ewan Morrison, Director of Pharmacy, NSS and Dr Sam Patel, consultant physician in Respiratory and General Medicine NHS Lanarkshire, and eHealth Clinical Lead for NES Digital Services. This programme is a major national collaboration between  NHS Education for Scotland and NHS National Services Scotland, and aims to revolutionize the way we prescribe and dispense medications in Scotland, which is currently a paper-based process with some electronic elements, involving medical and non-medical prescribers, patients and pharmacists, generating around 5 million items a month. In one of our previous episodes, we discussed the outputs of a series of NSS workshops held in 2019 looking at processes around prescribing. The findings acknowledged that ePrescribing is one of the key requirements to improve prescribing and dispensing processes. In this episode, Ewan and Sam discuss the outcome of phase 1 of this programme, which aims to find a technical and organisational electronic solution to meet the needs of NHS Scotland in the future, and has produced a paper prototype to inform this. “Once we have removed the paper prescription, and replaced the wet signature, from in-hours GP prescribing, to community pharmacy, and the process works for everyone in that chain, including the patients, the citizen, that's when we'll be cracking open the Champagne”. They will also be leading a plenary session at our November conference and you can hear more about the programme and ask them your own questions by registering below. The SNUG Virtual Conference November 2021 agenda and booking details NHS Digital EPS prescribing System Specification (specification for EPS in NHS England)

One of the big areas of interest at the SNUG members' day in May was the increasing use of digital systems for communicating and consulting “asynchronously” and how these are changing the face of general practice. In this episode, we have highlights from two of the talks discussing issues around online consulting. Thomas Dodd is a training partner for AskmyGP and he discussed some of the popular myths about online consultations – for example that patients prefer face to face rather than online contact, yet online services will also submerge GPs with new demand. Dr David Cooper, the co-chair of SNUG and a user of eConsult, describes why he is a big advocate of online consulting and why his practice has found it hugely beneficial in maintaining services throughout the pandemic. We pose the question: are we now at a similar moment in weighing up the pros and cons of providing a new means of access to care online, as doctors were in the 1880s when the advent of the telephone also offered new and better access to medical care? These workshops can be seen in full, with slides and questions and answers at the SNUG website. You can contact us with any comments or suggestions at: alex.defranco@phs.scot The Lancet on the telephone 1867-1975 Farewell Dr Findlay: the history of general practice: BBC Sounds NHS England: using online consultations in Primary Care implementation toolkit BMJ Health and care Informatics: COVID-19 and beyond: virtual consultations in primary care—reflecting on the evidence base for implementation and ensuring reach: commentary article BMJ How to conduct written online consultations with patients in primary care: visual guide  

The way we deliver health care has been radically changed by the Covid 19 pandemic. In an almost Darwinian way, general practices have evolved their systems to try and meet the various challenges, much of it driven by technology and the ability to communicate and provide services by telephone or online. Many practices now have what's been called a digital front door. The question is, how widely to we want to open up that front door? Practices across the UK have had to make new use of online services and are wondering rather uncertainly what the future implications of this will be. Is there a limit to the demands for health care? At the May SNUG Members' day, many of the new digital developments were discussed. Matt Hoghton (@mhoghton) is a GP and Clinical Advisor to Digital Primary Care NHSX in England. He described how services have developed in England in the last 18 months and described experiences with greater use of Digital Asynchronous Consulting Systems, apps and practice websites  to allow patients to access and use services in a new way, the need for remote working, e-Prescribing and how the organisation of health care has had to shift to meet the changed circumstances. There are many parallels with our experiences in Scotland, and also several lessons we can learn. Andrew Cowie(@DrAndrewCowie) is a GP in Dundee and the deputy chair of the Scottish GP's Committee of the BMA (SGPC). He led a discussion session looking at the SGPC's approach to provision of digital services by GP practices in Scotland. The full videos for these sessions and many more are available for members at the SNUG Website. Are you enthusiastic or apprehensive about the move towards opening the digital front door to your practice? Do let us know. alex.defranco@phs.scot SGPC information: https://www.bma.org.uk/what-we-do/committees/general-practitioners-committee/scottish-general-practitioners-committee Rammya Mathew BMJ: https://www.bmj.com/content/373/bmj.n1246 Future NHS Collaboration platform: https://future.nhs.uk/ NHS Inform tools and apps: https://www.nhsinform.scot/care-support-and-rights/tools-and-apps

In the 1970s and 80s the UK Government produced a series of film and leaflets intended to advise the public on how to protect themselves during a nuclear attack, called “Protect and survive”. In the wake of a recent massive cyberattack on the Irish health Service, which has paralysed their core health services, we remember the Wannacry attack on the NHS in 2017, consider how we have had to address cybersecurity since then, and how “Protect and survive” now might have a new meaning for us in the Digital age. Scott Jaffray is the Associate Director Facilities & Infrastructure and head of Digital & eHealth in NHS Forth Valley and he discusses the ongoing cybersecurity “arms race”, gives some tips for security at home, and describes how martial arts can provide a welcome distraction. An explainer on the cyberattack on the HSE: https://www.siliconrepublic.com/enterprise/hse-cyberattack-explainer-conti-ransomware The Scottish Government's cyber resilience policy: https://www.gov.scot/policies/cyber-resilience/ National Cybersecurity Centre top tips for staying secure online: https://www.ncsc.gov.uk/collection/top-tips-for-staying-secure-online Protect and survive film: https://www.youtube.com/watch?v=7yrv505R-0U&list=RD7yrv505R-0U&start_radio=1&rv=7yrv505R-0U&t=2786 The Dubliners' take on Protect and Survive: https://www.youtube.com/watch?v=elx0kqgemQQ SNUG website  email: alex.defranco@phs.scot 

In the week of an important Scottish Parliament election, we spoke to @DrChrisWilliams who is the co-chair of RCGP Scotland. Chris is a GP in Highland, with a special interest in IT and he discussed some of the consequences of the pandemic, as well as the current challenges facing general practice in Scotland. RCGP Scotland has developed its own manifesto, which was discussed by the parties at a recent hustings event. He highlights some of the most important requests from the profession for the new Scottish Government, to take the NHS, general practice, and GP Information Technology forward, over the crucial next few years. The work of RCGP Scotland The RCGP Scotland Parliamentary Manifesto BJGP editorial April 2021: Remote by default general practice: must we, should we, dare we? Hail Hail Freedonia! Contact SNUG via alex.defranco@phs.scot 

As Scottish GPs are starting to form cohorts within Health Boards, to prepare for selection of one of the next generation of GP IT systems, it will be essential to understand how each system delivers the requirements to become accredited and approved for use in Scotland Dr Beena Rashkes and Dr Andrew McElhinney of SNUG were joined by Shona Wares, Head of Product Management, and Margaret McCaul, National Account Manager for Scotland, margaret.mccaul@visionhealth.co.uk, for Cegedim Healthcare Solutions @CegedimHS. They share their “Vision for the future of digital health”. “Vision is a portfolio of products with a suite of applications, which can interact and be used across a variety of healthcare settings. You will have the required applications installed according to your needs, as well as the core GP system”. There is more information  for Vision users at: https://info.visionhealth.co.uk/gp-solution and some tips for users at: https://www.snughealth.org.uk/gp-software/vision/vision-user-tips/ More information about GP IT Re-provisioning is on the SNUG website: https://www.snughealth.org.uk/gp-it-re-provisioning/  or you can contact us via alex.defranco@phs.scot 

Professor Sir Lewis Ritchie has made an enormous contribution to both healthcare and technology in Scotland, over the past 40 years. He has been a GP partner in Peterhead, is still the James McKenzie Professor of General Practice at Aberdeen University, and he has also been Director of Public Health at NHS Grampian.https://www.abdn.ac.uk/iahs/research/profiles/l.d.ritchieHe has played a unique role in shaping the computerisation of Scottish Primary Care, having written a book on the potential of computers in primary care, chaired the Electronic Clinical Communications Implementation group,  carried out a couple of reviews of the Gpass system, helped set up the Primary Care Clinical Informatics Unit at Aberdeen University, and he has encouraged the Scottish Government to set up a national data and intelligence reporting service for Primary Care. He has long advocated the importance of innovation in computing and information technology in the delivery of optimal care.He has led a number of national programmes, notably the introduction of Meningitis C vaccine in Scotland, and chaired the steering group for the SIGN guidance on Cardiovascular disease prevention reflecting a long standing interest based on research in his own practice.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC139939/https://www.sign.ac.uk/assets/sign149.pdfHe was awarded an OBE for services to General Practice and Primary Care and, in 2011, received a knighthood for services to the NHS in Scotland.In a conversation with Dr Andrew McElhinney of SNUG, Sir Lewis discusses some career highlights, the significance of lifeboats, which of his many roles have given him most satisfaction, which may have had the most impact, how GP computing may develop in the future and we also speculate whether patients may start to come and request a “vaccine line” from their GP in the future!https://www.pressandjournal.co.uk/fp/news/north-east/1784256/famous-peterhead-lifeboat-goes-on-display-after-restoration/https://www.ed.ac.uk/usher/eave-ii/what-is-eave-iiFeedback and comments are welcome, to our Facebook page or Twitter, or by email to alex.defranco@phs.scot. More information on the Scottish National Users’ group is at https://www.snughealth.org.uk

In this episode, we discuss the options for recording Covid-19 vaccination data in Scotland. Options for GPs are to use templates or guidelines provided by your GP IT system (EMIS or Vision), or to use the TURAS Vaccine Management Tool.Janet Binnie is an eHealth facilitator in NHS Forth Valley, and a member of the Change Advisory Board. Dr Ian Thompson @ianmthompson is a GP in East Lothian and is Primary Care Clinical Lead in Digital Health and Care at Scottish Government and they have both been involved recently in describing the information requirements for collection of vaccination data for Covid-19 in Scotland. We discuss the practical issues involved for those recording vaccination data in Primary Care, as the immunisation programme gathers momentum.A video introduction to the TURAS VMTHints and tips for navigating TURAS Learn COVID-19 vaccination programme siteA guide to the TURAS Vaccination Management Tool including link to user guide

After a year which has left a lot of us searching vainly for a time travelling De Lorean, it’s time for some Christmas cheer, with a cocktail of reflection, positivity, and ideas for how we can look after each other, also develop to our full potential and look forward to a better future. We are joined for this episode by Dr Chris Weatherburn, the acting chair of Scottish Clinical Information Management in Practice, and he explains the work of SCIMP, reflects on a strange year, and discusses how to avoid both boredom and burnout, why you should “Fire bullets, then a cannonball” and also learn about the growth mindset.Just don’t think of a pink elephant…You can tweet Chris @chrisweatherbu1, or tweet SNUG @SNUsersGroupMichael McIntyre visits fortune teller before lockdown videoScottish Clinical Information Management in PracticeChris Weatherburn’s website

This episode features a review of SNUG's first virtual conference, which covered a wide range of current GP IT topics, in three plenaries and twenty workshops held via Microsoft Teams on November 10th. We feature some of the highlights, including some snippets from a talk by Dr Chris Weatherburn on data quality, a workshop by the national team on the Office 365, Teams and NHS Mail roll out, and some in-depth discussion of where we are currently with the GP IT Re-Provisioning programme for Scotland.Feedback and comments are welcome, to our Facebook page or Twitter, or by email to alex.defranco@phs.scotOffice 365 Champions siteNational Services Scotland GP IT Re-provisioning videoData quality in Primary Care Scotland - video by Chris WeatherburnOffice 365 Support siteSCIMP 2020 codelist

This month, we are talking to ourselves! Dr Neil Kelly @NeilGKelly reflects on his impressively long stint as chairman of SNUG, and the influence SNUG can have, and has had on strategy and providing support for GP IT users. He considers, as we head into an uncertain winter, how technology can best help us deliver health care and the need for us all to look after ourselves and each other. We have an update on the latest developments in the slow running GP IT Re-Provisioning project (at 14:58), a taster of what's in store at the forthcoming SNUG virtual conference (24:34), and we get a little insight into Neil's secret interests in fermented grape juice and sea-resistant light fittings as well as his favourite SNUG anecdote.https://www.snughealth.org.uk/events/snug-membersday-2020/

A main aim of the 2018 GMS Contract was to make GP workload more sustainable and this has resulted in the addition of many Health Board employed staff to work in general practice teams - pharmacists, ANPs, physiotherapists, phlebotomists and mental health nurses. National standards have been set for the IT hardware and systems available within general practices in Scotland.Dr Andrew Cowie @DrAndrewCowie is deputy chair of the BMA's Scottish GP Committee and a GP partner in Dundee. He helped negotiate the current GMS contract for General Practice in Scotland and this episode features a conversation between Dr Cowie and Dr Andrew McElhinney of the Scottish National Users' Group (SNUG) about the standards which have been set for GP IT currently, whether these are being met, and what the main needs are going forward.SNUG Survey: we are keen to gather thoughts from our members on how funding for the  new GMS contract has been used in each area, and this will aid discussions at the SNUG Virtual Conference in November.Programme and registration page for the SNUG virtual conference on November 102018 GP contractScottish GP Committee

NHS Scotland developed SCI Gateway in the early 2000s to allow secure communication of clinical data and enable GPs to make protocol-based referrals from Primary to Secondary Care. Over the years it has been used for many thousands of GP referrals, and also a much wider range of purposes including the requesting of advice from specialists, death certifications, infection notifications, and tertiary referrals. It has been adopted by the NHS in Wales and Northern Ireland. However the NHS now has to make a decision about the future of SCI Gateway in Scotland and consider whether to invest in its future, or whether it may be time to consider a new alternative product. We have discussions with Lesly Donovan, the General eHealth manager in NHS Fife, and John Wells, eHealth Project manager in NHS Forth Valley who consider some of our questions about how vital Gateway currently it is for the daily working of the NHS and is it really essential to keep it for the future?We would be interested in what other GP IT users think...

As we continue to develop new ways of working in Scottish general practice, face to face consultations are no longer the norm. Many practices are making much greater use of telephone and video consultations and good triage systems are essential to help patients use services most effectively. eConsult (@econsult_thinks) from WebGP is a platform which provides new and easier ways for patients to get help with a problem - whether through self help, online advice or via telephone, video or face to face contact where appropriate. It is all requested online through the practice website - which removes the need to phone the practice. This episode features a discussion with Dr Kris McLaughlin of Stonehaven Medical Group who spoke to Dr Andrew McElhinney of SNUG, along with other members of his practice team, to discuss the details of how best to get eConsult up and running, and what practical issues need to be addressed.What is eConsult, and how does it work?    eConsult demo siteLet us know if you have any comments on Twitter at https://twitter.com/snusersgroup or Facebook at  https://www.facebook.com/scottishnationalusersgroup

This month, we have a special edition of our podcast, starting to look at online resources for Clinical Decision Support, this time featuring a wide-ranging conversation with @medmyths James McCormack, Professor of Pharmaceutical Sciences at the University of British Columbia. We discuss why shared decision making about starting treatments is a vital part of Evidence Based Medicine, where many guidelines and the Quality and Outcomes Framework (QOF) may have got it wrong, and why Scotland's move to Realistic Medicine is to be applauded. We also discuss why lower doses of medicines are often better, how Homer Simpson can help you learn and what some of the beneficial outcomes from the Covid pandemic might look like.Visit James McCormack's YouTube site to see these educational videos and more: Evidence-based look at Clinical Practice Guidelines, Dose response curve, The surrogate battle - is lower always better?The Best Science Medicine Podcast looks at evidence for managing common  conditions seen in Primary care.The BSM CHD risk calculator not only calculates the 10 year cardiovascular risk but lets you easily see the benefits or harms of a range of interventions for that patient.As usual comments are welcome  via our Twitter or Facebook pages.

Graham Gault is the eHealth Lead for Dumfries and Galloway and he was involved in the Scottish Government deal with Microsoft to purchase Office 365 for the NHS. He speaks to Dr Neil Kelly of the Scottish National (GPIT) Users Group (SNUG) about how he expects #office365 and @MicrosoftTeams to start to transform the way the NHS works, providing new opportunities for flexible and collaborative working online. We will be able to share documents and other files much more easily, also speak and meet online, with an impressive reduction in the need to travel and improvements in cybersecurity.The pandemic has increased the need for remote working and been a catalyst for rapid change within the NHS. General Practices can start to benefit now from this new ability to work, meet with colleagues remotely, and share documents in the Cloud. This will greatly ease the difficulties caused by the current need to save files within local systems. NHS Scotland will also get a new email system later on this year as NHS Mail is replaced."Massive opportunities...the industry is changing, and our single message is that people have got to change and embrace this", says Graham.Learn more about how to use MS Teams at:NHSScotland - An introduction to Microsoft TeamsNHSScotland MS Teams knowledge baseMS Teams - short training videos