Scottish National Users' Group (SNUG) Podcast

From information overload to actionable knowledge

In this festive episode, we welcome Dr. Chris Weatherburn back for an annual end-of-year chat, reflecting on a year marked by the news that One Advanced have taken over the Vision system and there have also been many AI products starting to make an impact on general practice. Chris outlines three key areas: ambient voice technologies, workflow automation, and decision support. He notes the tension between AI's exciting potential and the necessary caution required in healthcare, referencing the pause on Project Foresight after ethical concerns and the SG guidance urging practices to hold off on ambient voice tools until proper assessments are completed. We consider how GPs are navigating this complex landscape, with SNUG playing a vital role in helping practices implement new technologies correctly.

Chris also shares book recommendations, highlighting John Kotter's work on change management and Ronnie O'Sullivan's Unbreakable, drawing parallels between elite performance and general practice—particularly around maintaining positivity, managing negative thinking, and finding sustainable success. The conversation turns to the challenges facing Scottish general practice, including the recent funding offer by the Scottish Government for general practice and digital access improvements, the loss of SCIMP's independent guidance role, and the upcoming NSS/NES merger. We reflect on the importance of embracing change while learning from others' experiences, with Chris emphasising that SNUG remains well-placed to support practices through the transitions ahead.

Strategy as Change: Kotter’s New Approach

14 Life Lessons from a Snooker Legend - Unbreakable

NotebookLM Guide: Google's AI Study Hack You Need for Faster Research

Chris’s plenary on AI at the 2025 SNUG conferencee

From Information Overload to Actionable Knowledge: NotebookLM’s AI podcast explaining Chris Weatherburn’s websites

The NHS Digital SNOMED CT Browser

Will ye gang tae the Highlands?

We explore the realities of working in a general practice in a remote rural area of northwest Scotland, highlighting the unique geography, distances from hospital care, and the way these factors shape clinical work, patient access, and continuity of care. Andy Vickerstaff, the practice manager for Aultbea and Gairloch Medical Practice, describes how long travel distances profoundly influence decisions about referrals, out-of-hours provision, and the breadth of services the practice must offer - including roles that extend beyond medicine into social support and immediate care. He contrasts their experience during and after the pandemic with more urban practices, noting how telephone consulting became embedded, while video consulting (NHS Near Me) never fully took off locally. Accessibility remains strong in their setting, avoiding the pressures for access to care seen in larger practices and enabling a high degree of continuity, particularly in palliative and end-of-life care.

The discussion also examines digital systems, AI, and the need for better national guidance. Andy describes using AI tools like Copilot for administrative tasks - including translating and summarising complex foreign medical records - which he sees as transformative. We rue the demise of SCIMP, once a key Scottish body providing authoritative guidance on coding and information management. Andy argues that with all Scottish practices moving to Vision, there is a major opportunity to re-establish centralised, consistent IT and coding guidance to avoid a fragmented approach across 14 health boards. Finally, he reflects on practical IT challenges for independent practices, identifying primary care finance and payroll systems - especially NHS pension processing - as an area urgently in need of a modern digital solution.

Aultbea & Gairloch Medical Practice

Primary Care Informatics – formerly known as SCIMP

Guide to Scotland's North-West Highlands: where to stay, places to visit and great walks

Culture: Beard, sandals, stethoscope

Medics of the Glen (needs STV account)

Will ye gang tae the Highlands, Leezie Lindsay

Donald Where's Your Troosers

Digital Prescribing and Dispensing Pathways… progress?

In this episode, we speak with Dr Sam Patel, National Programme Lead for the Digital Prescribing and Dispensing Pathways (DPDP) Programme, to explore Scotland’s progress toward replacing paper prescriptions with a secure, end-to-end electronic system. Sam explains the legal and technical foundations required to make the transition — from implementing advanced electronic signatures compliant with UK and EU standards, to the key legislative amendments for the programme. We discuss how Scotland’s infrastructure differs from England’s EPS “Spine” system and how the new approach, built on the National Digital Platform, will need to support national identity verification, secure messaging, and audit capability across GP and pharmacy systems.

Looking ahead, Sam outlines the project’s timeline, challenges, and expected benefits. The first pilot sites are targeted for late 2028, following the appointment of a delivery partner and integration with new GPIT and pharmacy systems. We discuss the enormous potential for reducing admin time, improving patient convenience, and creating better repeat-prescribing processes — all while ensuring those who are less digitally enabled aren’t left behind. We also touch on moves towards a consolidated medication record, ECS replacement and the Digital Front Door plans for Scotland.

About the Digital Prescribing and Dispensing Pathways (DPDP)    DPDP Animation

NHS Scotland National Digital Platform (NDP)

Human Medicines Regulations 2012 (legislation.gov.uk)

Electronic Communications Act 2000

Community Pharmacy Scotland

SNUG – Scottish National Users Group  

Queries and comments to: alex.defranco@phs.scot

Agenda for SNUG Virtual Conference        Register here

James McCormack discusses the Scottish Cardiovascular DES

In this episode, we discuss the Scottish Cardiovascular DES designed to reduce adverse cardiovascular events by tackling population-wide risk factors like high blood pressure, raised glucose and cholesterol. Professor James McCormack suggests a greater focus on shared decision making with patients,  arguing that the common 10% risk threshold used to trigger treatment is an arbitrary figure that often fails to clearly define what the risk actually entails. He contends that most guidelines can overlook the individual. With years of experience of teaching how to explain and apply evidence, using humour, he advocates for a foundational shift toward a patient-centred model, where treatment decisions are made with patients, not for them.

The conversation explores how to put this philosophy into practice. Risk calculators such as ASSIGN and QRISK should not be used as diagnostic dictators, but as educational tools to start a conversation. He is highly critical of using terms like "pre-diabetes" or "high risk," which can cause patients to vastly overestimate their danger and create unnecessary anxiety. The solution is clear communication: using visual aids and explaining absolute benefits - for instance, a statin might change a 10% risk to 7 or 8% over a decade. By moving away from rigid protocols and chasing fluctuating measurements, clinicians can reduce patient fear, build trust through shared decision-making, and ultimately rediscover a more enjoyable and effective way to practice medicine.

National cardiovascular disease (CVD) prevention and risk factors toolkit

GP Evidence – fantastic site for GPs interested in shared decision making and using patient decision aids, created by Dr Julian Treadwell

Complete BS Medicine podcast list – includes the Contented Clinician podcast

ASSIGN v2 Cardiovascular calculator

PEER simplified Cardiovascular Decision Aid

NICE guidance on shared decision making

James McCormack YouTube videos

The Surrogate Battle - is lower always better?

You can subscribe to the SNUG podcast on the following platforms:

SNUG podcast on Apple podcasts      SNUG podcast on Spotify

Any feedback or comments are welcome via email: alex.defranco@phs.scot    www.snughealth.org.uk 

GP IT Re-Provisioning – emergency podcast

In this “emergency” podcast we focus on the major announcement that One Advanced has acquired the Vision system, bringing long-awaited clarity after months of uncertainty following INPS’s administration last December. Dr David Cooper and Dr Bill Martin, co-chairs of SNUG, discuss the relief this brings to Vision practices, staff, and NHS teams who had been left in limbo. They reflect on the resilience shown by Vision’s workforce during this challenging period and explore the practical implications for practices now facing rapid transitions. While some EMIS users had quietly hoped for a different outcome, the contractual and financial reality meant that finding a buyer for Vision was the most feasible path forward.

The conversation also explores the potential benefits and risks of having a single supplier for both Vision and Docman 10, including opportunities for better integration but also concerns about market competition and innovation. While the migration will be demanding, with practices needing strong change management and training, practices will be supported by trainers and facilitators through the process. Ultimately, the mood was one of cautious relief: challenges lie ahead, but GP IT Re-Provisioning can now move forward after a prolonged period of uncertainty.

OneAdvanced completes the purchase of INPS Vision assets

Voltage Control—“Change Management for Dummies

SNUG Registration - SNUG Hints and Tips Day 2025

Changing GP system: the Tollcross experience

At the SNUG Members’ Day, a workshop featured Dr. Keith Mercer discussing his practice’s migration to the Vision IT system, in an interview with National Facilitator Manager Dawn Ellis.

Preparation
The team used checklists, spreadsheets, and searches to prepare for the move from EMIS. Keith and the Practice Manager dedicated around 10–12 hours to data mapping, alongside routine work. Staff completed short e-Learning modules on the Vision training system and benefited from early adopter on-site training.

Migration & Go-Live
During migration, the practice offered urgent appointments only and kept patients informed. EMIS was still used for appointments and prescriptions, while clinical notes went into DACS before transferring to Vision. On go-live day, staff relied on trainer support. Controlled drug prescriptions were quickly added to Vision, and others were scanned into Docman.

Post-Migration & Outcomes
The first few weeks were challenging, with staff adapting to Vision and experiencing mental fatigue. Issues included printing prescriptions and Med3s, learning Vision Tasks, and setting up Mail Manager. However, the practice now appreciates Vision’s efficient search, recalls, and modular layout. Keith advises that practices allocate plenty of time for training and preparation and not to underestimate the effort involved in the transition but concludes Vision does have some good functionality, such as better prescription and record-searching capabilities, and stresses the importance of adequate staffing and additional support during early migration stages.

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

General Practice: Progress since the 2018 General Medical Services contract: Paragraph 50: “The Scottish Government acknowledges that Primary Care data and the infrastructure to support it is inadequate and has said that improving this situation is a priority”.

Johnny Logan: what’s another year

 

What new products could you be using?

In this episode we hear from some system suppliers who were exhibiting at the recent SNUG Members’ day.

Numed’s Simon Healy explains how their ECG, spirometry and blood-pressure devices can integrate with a GP system, Caitlin Collins and Elliot Shaw from Microtech discuss Surgery Pod, a self-service computer system that captures blood-pressure, height, weight and lifestyle data in the waiting room. Eleanor Rafe from Accurx reports that some Scottish practices are now using its two-way messaging and booking-link features to cut phone traffic and provide asynchronous chats.

Sharon Hanley and Dani Henderson from X-on Health describe its Surgery Assist chatbot—which begins by texting callers in the phone queue a link to an online symptom-checker and local service sign-posting—with the Surgery Connect cloud telephony platform that shows patients their real-time queue position and offers automated callbacks. And, finally, Rick Thompson from One Advanced describes their new AI agents which could work inside Docman 10: one summarises long discharge letters, another suggests SNOMED codes, and their forthcoming UK-hosted large-language-model (One Advanced AI) which will let clinicians query clinical records in both Docman, and Vision for a summary of entire patient records – once the Information Governance agreements are in place, of course.

Imagine a new world in which practices could use integrated devices, smart telephony and trustworthy AI to relieve the 8 a.m. rush, ease the increasing administrative and cognitive load, provide new and smarter ways of working and reclaim clinical time…

SNUG Members’ Day video links (SNUG Membership needed)

NHS England Guidance on the use of AI-enabled ambient scribing products in health and care settings

Ambient Voice Technology AI checklist for clinicians (Dr Gandalf eGP Learning video)

Feedback or comments are welcome: alex.defranco@phs.scot    www.snughealth.org.uk 

Using a magic wand to fix the NHS in Scotland

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

A conversation with Dr Margaret McCartney

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’s new functionality

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