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Good morning to the panel. I want to focus on the signposting journey. Throughout the evidence that we have taken so far, we have heard that one of the barriers to signposting is perhaps the constantly changing landscape of service providers. There are also barriers for patients in relation to communication and understanding what is available. How can we improve people’s understanding of what is available and the communication that exists to let people know about it?

That is very helpful.

I thank the panel for those responses.

I heard what Harjit Sandhu said about the GP traditionally being the gatekeeper. I think that people are trying to find other avenues. However, some of the written submissions that the committee has received, particularly from the health and social care partnerships, suggest that there is still nervousness about people on a self-referral pathway going from pillar to post and ending up in an emergency setting, because there is no relationship with the first point of contact—the GP.

Do we need to drill down into that to understand who needs to go via the GP as the first point of contact in order to access other services? After all, as some of the panel’s answers have suggested, self-referral might be easier for some people than others. Is there an acceptance that we need to look at individuals and their needs?

Good morning, panel. We have already touched on self-referral pathways, but I am interested in the public’s awareness of self-referral. We know that there are initiatives out there, such as pharmacy first, which we have talked about a bit, and the NHS Greater Glasgow and Clyde right care, right place web resource, which tells people where they should go and when. According to research that has been done for the inquiry, public awareness of some of those initiatives is not always high; in particular, public awareness of when to self-refer outwith pharmacies is not high. I think that a lot of people are aware of the pharmacy avenue, but perhaps not other avenues.

My first, broad question, therefore, is: how can we raise awareness of self-referral and people’s ability to self-refer? As I have mentioned pharmacies, I ask Clare Morrison to answer that question first.

Is your sense that it is working effectively when someone is signposted to an AHP or whoever and they go on that journey, or do people sometimes go round the houses, for want of a better expression, and end up back at the GP?

Last week, we heard some evidence about the requirement for protected learning time for everyone who is involved in a practice, which includes reception staff. Other people have talked about how we can protect that time properly. Dr Marshall, I do not know whether you have had experience of, for example, being part of NHS 24 or of covering phone lines in your practice, but I believe that that there might be ways of ensuring that people feel that they are getting a service from their practice while putting in place protected learning time for everyone who works in the practice. Can you say something about that?

Yes. Thank you, convener.

Margaret McKay’s observation was helpful, because public transport is a key issue in reducing isolation. However, does anyone else have a reflection on the digital element? We see challenges with library services and other places where people normally access IT if they do not have regular access. Obviously, the situation has been compounded by the pandemic, but there are challenges with the availability of services that are run by local authorities. Macmillan Cancer Support offers a cancer service in many libraries, which is helpful and welcome. Do we need more engagement with library services and more funding for them, perhaps from the health stream, to support libraries as hubs?

Good morning, panel. The theme that I am focusing on is the patient perspective. You have already said a lot about that in your answers, which is most helpful, but perhaps I can drill down a wee bit into what patients said in response to our call for views. One thing that they highlighted is a negative perception of reception teams in general practice. We can all probably relate to some of that. When we consider people’s attitude towards those staff, they are often seen as gatekeepers or, negatively, as barriers to seeing a GP, which is often wrong.

How can we communicate better on the triage pathway that now exists in many practices? Triage pathways are perhaps clearer in emergency medicine than they are in general practice. I am keen to understand your experiences of that and how we can continue to communicate with patients.

That was a helpful answer. You mention how to create space for training, perhaps by diverting people to other pathways, and NHS 24 having a bit of a support role. What are your experiences of things like NHS 24? I know that people are directed there more often as an alternative to presenting at accident and emergency but, in the past wee while, we have seen frustration with the accessibility of that service, with 240,000 unanswered calls in a two-month period. The convener mentioned frustration with phones ringing out at GP surgeries, too. Are our alternative systems for phone advice up to par and able to support people?