One in ten Scottish GP practices taken over by health boards

Almost one in ten Scottish GP practices has been taken over by health boards as staff shortages force partners into handing back their contracts.

New data showed 76 GP surgeries out of 910 in Scotland (8.4%) are being run by a health board, or ‘are heading in that direction’, The Herald newspaper found.

The percentage has grown from 6.9% in 2019, when 59 out of 943 GP practices were run by health boards.

One of the largest recent takeovers included a GP practice in Inverurie caring for more than 25,000 patients announced last month it will be handing back its NHS contract because there ‘simply are not enough trained GPs out there’ to recruit.

And, according to the BMA, about 2,000 new GPs are required to satisfy demand across practices in Scotland.

BMA’s Scottish GP Committee chair Dr Andrew Buist told Pulse that almost no practice can consider themselves ‘immune’ to the recruitment and retention problems that could force them to give up their contract. 

He said: ‘Overall progress on delivering the 2018 contract has stalled and no progress at all has been made with the contract’s Phase 2 plan to expand the GP workforce where patient need is greatest, to directly reimburse practice running costs, and reduce the variance in GP earnings in a way that would benefit health inequalities.’

He said there has also been failure to develop a solution to create new practices in those areas of Scotland witnessing population expansion due to a local house building boom, and to invest in the GP premises estate such that many are ‘in a very poor state of repair and are inadequate to meet the needs of modern patient care.’

‘GPs across Scotland report that the present situation is dire and is only going to get worse without intervention,’ he added.

Dr Patricia Moultrie, medical director at Glasgow LMC, told Pulse: ‘We are aware that some practices are under pressure and are considering to hand back their contract and we are concerned about that.

‘Practices consider that because of recruitment and financial issues, and the partnership model is becoming an increasingly unattractive option and GPs are reluctant to take on that responsibility.  

‘Having health boards running GP practices is an expensive model of providing care and we have concerns around the management resources that health boards have to spend do that, as well as continuity of care, as there are challenges around that too.

‘They are thinking short term but we have to be concerned about the future of these practices and the long term impact of the model.’

Dr Andrew Cowie, a GP in Dundee and SGPC negotiator, said that a GP practice being taken over by the health board is often ‘only the second worst option for patients.’

He said: ‘All too often no GP in Scotland can be found to work there, the practice is abandoned and patients are scattered to nearby practices.

‘Sometimes nearby practices are also short of doctors, but patients can be forcibly allocated anyway. Across the UK this has led to further collapses, and a domino effect across wide areas.

‘Once started this process is very difficult to reverse, it’s often referred to as a “death spiral”.

‘Even for new GPs who choose to stay in Scotland rather than following their colleagues leaving the UK, why would they work somewhere that is clearly already short of doctors?’

Inverurie Medical Group, which runs one of the largest practices in Aberdeenshire, announced it will hand back its contract with NHS Grampian on 7 September.

Aberdeenshire Health & Social Care Partnership, which already manages six other GP practices in the region, including Mintlaw and Aberchirder, is expected to take over.  

Fyvie Oldmeldrum Medical Group, near Inverurie, which serves 8,974 patients, also ended its contract on 17 April due to staff shortages.

Meanwhile, the last single-handed GP practice in Edinburgh will close this summer, with almost 2,000 patients needing to be re-registered elsewhere.