Uncertainty for 6500 Arbroath patients as GPs quit and deadline for practice closure looms

The crisis has been sparked by the imminent retirement of two of the practice's partners, who are due to step down in July.

The move would have left just one GP partner with sole financial responsibility for running the surgery, and a salaried GP.

With rural general practice facing a recruitment crisis - especially over a shortage of doctors willing to become partners - there was little prospect of the retiring GPs being replaced.

As a result, the Abbey Practice medics notified NHS Tayside in January of their decision to end their contract to provide primary care services as of July 31.

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In recent weeks meetings have been stepped up between NHS Tayside, Angus Health and Social Care Partnership, the GPs and local politicians in a bid to find a solution, but there is still no plan for a replacement service after this date.

The two closest - Springfield Medical Centre and Arbroath Medical Centre - already have patient lists of 12,000 and more than 9000 respectively and are not believed to be in a position to absorb the Abbey patients.

A survey will be distributed by the health board to the patients this week asking for their views and priorities.

In most cases, health boards can take over the running of GP practices when partners quit by switching to what is known as a '2C' model, but this is more expensive for taxpayers and depends on being able to attract salaried GPs - something that is more challenging for rural areas.

It is understood that another option being considered is a 'hub' model which would see resources, including staff, shared with neighbouring practices.

Graeme Dey, MSP for Angus South, said: "Realistically there are three options.

"There's the 2C option, there is one that potentially sees the creation of a sort of hub model for Arbroath and the surrounding area, and then there is the nuclear option which we'd rather avoid where the practice shuts and the patients have to allocated elsewhere.

"I don't think that's in anyone's interests.

"I'm aware that there have been discussions taking place this week with the other GPs in Arbroath about what are the realistic options - what is deliverable and sustainable.

"I'm heartened that there is clearly work going on, as it needs to, to find a way forward.

"But time is not on our side and the timing of this could not be worse with the pandemic because the health service is so focused on addressing everything that flows from that.

“I can't sit here and say there is a clear way forward - there isn't - but I am satisfied that there is an enormous amount of work going into finding away forward.”

General practice has struggled to attract trainees as an increasing share of young doctors have pursued careers as consultants instead.

READ MORE: Number of GP partners in Scotland slumps to a record low

There has also been a growing reluctance among younger members of the profession to take on the burden of becoming a GP partner - that is, having a financial stake in the practice with responsibility for how it is run, the rent, overheads and upkeep of premises.

In the past 15 years, the percentage of GPs in Scotland who are salaried has soared from 4 per cent to 21%, while the proportion of GPs who are partners has shrunk from 85% to 66%.

At the same time, some older doctors have been spurred to retire earlier than planned due to pension tax changes which left higher earners out of pocket, while an increase in part-time working has contributed to a real-terms decline in the size of the workforce.

It is not the first time that Tayside has faced a crisis in its GP provision.

NHS Tayside previously stepped in to take control of Brechin Health Centre after two GP partners left and replacements could not be found.

Mr Dey said a sustainable solution had to be found.

"This isn't about applying a sticking plaster - we have to find a way forward that ensures there is an appropriate access to services for these 6000 individuals.

“We obviously need this to move on, but we need it to move on in a way that doesn't just provide a temporary solution. It's about what does this look like for the months and years ahead."

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The Herald contacted Abbey Health Centre directly but they declined to comment.

A spokeswoman for NHS Tayside said: “The Abbey Practice served six months notice in January, with their contract to deliver primary care services due to end on 31 July 2020.

"The Angus Health and Social Care Partnership and NHS Tayside have been working alongside the practice and colleagues from other local GP surgeries to review the ongoing situation.

"They are considering the arrangements which may be put in place to ensure primary care services are delivered to the people of Arbroath and surrounding areas going forward.”