Elected Member Briefing - Invergowrie GP Practice

About this briefing note

Report by: Jacquie Pepper, Chief Officer, Health and Social Care 

Date: 20 February 2023 

Subject: Invergowrie GP Practice  

Responsible Officer: Evelyn Devine, Head of Health 

Purpose

This briefing provides elected members with information about the work underway to address the challenges in relation to provision of GP services for patients registered with Invergowrie GP Practice.  

Briefing Information

Please see attached briefing below prepared by NHS Tayside Primary Care Services Department. This is also shared with members of the Perth and Kinross Integration Joint Board.  A similar process will be followed by Dundee Health and Social Care Partnership to inform Dundee City Council elected members and members of the Dundee Integration Joint Board.  

Invergowrie Medical Practice has a contract with NHS Tayside to provide General Medical Services (GMS) to patients registered with that practice. The practice is managed by a singled handed GP and is supported by a range of other health services.  The GP who operates Invergowrie Medical Practice also holds another contract to provide GMS to patients in the Ancrum Medical Centre Practice in Dundee. 

The contract to provide GMS at Invergowrie requires the practice to provide a full range of General Practice services to its population.  Patients registered with the practice live in the Carse of Gowrie, the west end of Dundee and in and near Muirhead and Liff. 

An inability to recruit following retirements at both the Ancrum and Invergowrie practices has now left a single GP managing both practices.  That GP did not feel that this was safe or sustainable, so has chosen to resign from the Invergowrie contract. 

In recent years, many practices across the UK have found it difficult to recruit GPs.  The reasons for this have been complex, and include a reduction in the percentage of newly qualified doctors wishing to train in General Practice; an ageing workforce; and a changing work balance in those specialising in General Practice.  This has led to an increasing number of practice closures and mergers across the UK. 

To protect good access to GP services within local communities, NHS Tayside has developed a number of programmes to support the recruitment and retention of GPs within Tayside.  This has helped a number of practices but there are still a significant number of GP vacancies across Tayside.  

Unfortunately, to date there has been no success in the recruitment of additional GP or other clinical time to support the practice.  Both the practice and NHS Tayside are continuing active recruitment measures. 

Invergowrie practice predominantly looks after patients who live in the local authority area of Perth and Kinross.  The practice has been aligned with nearby Dundee practices and as such, initial discussions with the practice were between representatives of NHS Tayside and Dundee Health and Social Care Partnership (HSCP).  When it became apparent that the practice wished to surrender its GMS contract, these discussions were extended to include representatives of Perth and Kinross HSCP. 

A working group has been established, including representatives from NHS Tayside Primary Care Department, NHS Tayside Corporate Communications and Finance Departments, Perth and Kinross HSCP and Dundee HSCP.  

This working group is now taking forward an options appraisal and will agree an engagement plan to keep patients informed. 

Advice to the working group has been to prioritise communication with patients.  For this reason, there was a decision that communication that directly affects patients should always be with patients first. 

NHS Tayside, Perth and Kinross and Dundee HSCPs are working together, at pace, to carry out an options appraisal to determine how we move forward and agree a realistic timeline.  Options that are likely to be considered include:  

1. A procurement exercise - Invitation to submit a business case for another GP  Practice to take over the practice contract 
2. Merge with another independent practice  
3. Merge with one of the two Dundee practices already operated directly by NHS Tayside 
4. Operate the practice directly by NHS Tayside 
5. Close the practice and disperse patients across other practices in surrounding areas 

Factors to be taken into account any decisions that are made include:  

• consideration of how best to provide locally based care to patients 
• assurance that care is sustainable 
• assurance that any change will not destabilise other GP practices in the area in a way that would impact negatively on the wider patient population 

The outcome of the options appraisal will be presented to Perth and Kinross and Dundee IJBs for comment as the practice cares for patients who live in both HSCP areas. As practice contracts are held at Health Board level, the final decision on the option (s) to be taken forward will be made by NHS Tayside. 

All registered patients will be kept fully informed of the details and arrangements which will ensure access to safe sustainable primary care services after the 16th June 2023. 

We hope this update provides clarity of the position and reassures patients that their healthcare is a matter of priority and that they will continue to have access to GP services. 

Patients who are registered with the Invergowrie practice should, in the meantime, continue to access GP services from the practice and we ask all patients to remain on the practice list until the outcome of the options appraisal is completed and a decision is taken by NHS Tayside.   

This is very important to secure the long-term viability of the practice should a solution emerge that keeps it open; avoids excessive demand on nearby practices; and keeps patients with a team that is aware of and responsive to their medical needs.