A MAJOR review looking at how General Medical Services (GMS) are delivered across Dumfries and Galloway has reached its next stage, with an update presented at Tuesday’s meeting of the region’s Integration Joint Board (IJB).
GMS refers to the everyday care provided by local GP practices – including GPs, Practice Nurses, Healthcare Assistants and the wider members of the multidisciplinary team (MDT) who work together to support patients.
The review was first mandated by the IJB in December 2024, with the scope formally approved in June this year. Its purpose is to examine how GMS is delivered locally, within the framework of the 2018 national GMS Contract and Memoranda of Understanding, and to consider what options exist to make services more sustainable in the face of workforce pressures, premises challenges and the unique realities of rural delivery.
Strategic Planning and Commissioning Manager Gillian Coupland said: “This review is about listening carefully to those delivering, supporting and relying on general medical services across our region. We want to capture what is working well and, just as importantly, where things can be strengthened for the future.
“Workforce, premises and the impact of rurality are all well-known challenges here. By engaging with GP practice teams, partner organisations and members of the public, we’re building a clearer understanding of what’s really happening on the ground.”
The review is being carried out in four phases:
Phase One (January – June 2025) focused on defining the scope.
Phase Two (July – September 2025) has centred on a programme of workshops and stakeholder engagement, now nearing completion.
Phase Three (October – December 2025) will test emerging thinking and continue conversations with stakeholders.
Phase Four (January – March 2026) will involve detailed analysis and action planning, turning findings into clear proposals for change.
Phase Two – currently nearing completion – has centred on a programme of workshops and stakeholder engagement sessions.
These workshops used an Appreciative Inquiry approach, inviting participants to share experiences, identify strengths, and explore possibilities for change.
Attendance was particularly strong from GP practice teams, with events in Annan, Newton Stewart and Castle Douglas each drawing dozens of participants, and a particularly high number in Dumfries. Public sessions were more lightly attended, though contributions were still valuable. In one case, a single participant provided insight from three different perspectives: as a patient, a former GP practice team member, and a system partner.
Emerging findings highlight shared concerns around access, continuity, sustainability and quality of care. While different groups bring different perspectives, continuity has been consistently identified as an essential element to protect in future models.
The agreed scope of the review focuses on six themes: service delivery, workforce, digital, data, premises, and quality – all considered through the principles of equity, integration and sustainability, and aligned with Scottish Government’s national route map for reform.
Next steps include detailed thematic analysis and synthesis of engagement feedback, supported by digital tools to help identify patterns and insights.
After this, further engagement is set to take place – with a call made today at the IJB for the widest possible public participation. This will be taking place across the months of October and November, with plans being explored to engage via existing external groups and meeting structures.
Following on from the update to the IJB this week, a full report is due in December once the next phase concludes. The final action-planning phase will take place early in 2026.
Ms Coupland said: “We’ve had open and honest discussions, and although perspectives differ there’s strong consistency around what matters most.
“The next stage is about pulling this together into clear options for action. The aim is to make sure general medical services in Dumfries and Galloway are safe, person-centred, equitable and sustainable for the years ahead.”