Health boards have stepped in to save dozens of Scottish GP practices from closure in the last six years, with more predicted to shut their doors in coming months, an investigation has found.

In 2022, 11 practices across Scotland – including Alness Medical Practice in Ross and Cromarty, and the island-based Barra Medical Practice – were taken over by the health board because no GPs could be found to take over contracts after previous partners retired or quit.

Figures analysed in conjunction with The Herald by independent, investigative journalism co-operative The Ferret found that at least 60 practices had have health board involvement – 31 of the practices had been taken over by NHS boards since 2016 with most of the others folding before October 2015 when the current data was first made available.

Two – the Edinburgh Access Practice and the Challenging Behaviour Practice in Edinburgh – are run by NHS Lothian. Glasgow’s homeless practice is run by NHS Greater Glasgow and Clyde.

Health boards are responsible for patient lists when practices shut their doors and seek to contract new GPs when practices are forced to close.

The investigation found those willing to take over include a growing number of GP “chains”, which operate multiple practices.

These include Barclay Medical Group, which runs seven practices and Alba Medical Group which has taken over 10 practices in the last five years.

Alba Medical Group – which has two partners – currently has practices in Lanarkshire, Erskine, Dumfries and Galloway, and Forth Valley.

It operates under various other names including Lanarkshire Medical Group and Forth Medical Group. An additional partner is listed at Bargarran Medical Practice.

READ MORE: Scotland's health care front line: Stress, burnout and soaring waiting lists

Some of its practices employ a small number of salaried GPs, while others do not.

However, it operates a “multidisciplinary model” involving a wide range of healthcare professionals.

In total, Alba Medical Group claims it hires 200 members of staff across its 10 practices. Among practices run by Alba are those which form part of Lanarkshire Medical Group, which took over the contract from the Lanarkshire health board in 2018.

It runs one surgery in Strathaven, two in East Kilbride, and another in Lanark.

In total, over 30,000 patients are listed at the practices. Only the two partner doctors are registered in holding the contract.

They are currently looking for a salaried GP to provide unscheduled [emergency] care, paid at a salary band of £99,000-£117,000 per year The multi-site practice says it has a “large multidisciplinary team” including nurse practitioners and physician associates – medically trained, generalist healthcare professionals, who work alongside doctors. It claims a total of 16 GPs work at the practices.

In a recent job advert, Alba Medical Group said it was working in “a different way from traditional General Practice”.

The Ferret has heard from people across Scotland who are struggling to access GP practices due to the acute shortage of doctors.

But some politicians raised concerns about the model being operated by Alba Group Medical practices, including at practices run by Lanarkshire Medical Group.

Lanarkshire Medical Group said its model was “entirely in keeping with the Scottish Government vision for primary care” consisting of “expert medical practitioners leading multi-disciplinary health teams”.

READ MORE: Scotland's GPs in numbers: How are Scottish GPs funded and what are they paid?

Dr Lisa Cameron, SNP MP for East Kilbride, Strathaven and Lesmahagow, shared details of six letters she had written to Lanarkshire health board in connection with concerns about the practice dated between October 2020 and January 2023.

The Ferret has also seen a letter she wrote to Cabinet Secretary Humza Yousef in July 2021, raising concerns about constituents struggling to access the practice.

Her constituency caseworker is currently dealing with complaints from 35 constituents.

The Ferret spoke to two patients of the practice who shared complaint letters raised about practices that are part of the Lanarkshire Medical Group.

One progressed her complaint to the Scottish Ombudsman in August 2021.

She received a reply a month later telling her the practice would now be in touch to discuss her complaint but has not heard anything since back. She said that while she was still unhappy about the service offered by her practice, she had “given up”.

Dr Lisa Cameron said “Many complaints are from constituents who tell me they can’t get through on the phone at all and others say they cannot obtain a face- to-face appointment.

“Those who have been offered an appointment after persistence appear to often be told they have to see another practitioner, like a practice nurse, despite requesting and wanting to see a GP.”

READ MORE: Private health firms 'prioritising profit over care' with appointments costing £250

She added: “The level of complaints indicates constituent concerns that are systemic and ongoing. NHS Lanarkshire do not appear to have adequately addressed this, despite my raising it repeatedly, and I believe the same medical group have subsequently taken on more and more practices.

“I was told by NHS Lanarkshire managers this is the way forward because the practice is multidisciplinary but my experience is constituents often can’t see a GP when they feel they need to clinically, which is extremely concerning to me.”

In last year’s health and care experience survey, just 21% of respondents gave Lanarkshire Medical Group a positive rating, the second lowest in the country.

Lanarkshire Medical Group said that it would expect its rating to be low as it had taken over failing practices.

It said there were “significant underlying problems including a serious and significant backlog of clinical letters” when it took over.

A spokesperson added: “It would be unrealistic to believe that such shortcomings and failures would be resolved immediately, but we have established a patient participation group to improve delivery and address any concerns.”

Concerns about two practices in Moffat and Lockerbie – also run by Alba Medical Group – were raised by local MSP Oliver Mundell last year. In a question in the Scottish Parliament on September 29 last year, he said he had “been inundated with concerns from constituents in Moffat and Lockerbie who are struggling to access GP appointments”.

In parliament he continued: “They report that there are frequently times when no GP is available to see anyone face to face and that they offered telephone consultations only, which forces people towards accident and emergency departments. I and other local representatives, including the chair of Lockerbie community council, who is in the public gallery, have raised concerns with the health board, but it refuses to intervene.”

Alba Medical has since confirmed it will withdraw from the contract.

A spokesperson said: “Alba Medical Group is structured to ensure the highest quality healthcare provision. We provide a care model that is GP-led at each location and uses a mix of allied health professionals (AHPs) to meet the needs of local patients. The model includes GP partners supported by a senior management team responsible for the effective operation of the practices.

“The GP-led multidisciplinary team includes a mix of advanced clinical nurse and paramedic practitioners, practice nurses, clinical pharmacists, physician associates, mental health workers, and lifestyle advisers such as social prescribers. The utilisation of our wider teams and clinical hubs in Lanarkshire and Forth Valley supports the whole organisation by provision of back-up clinical and admin support, ensuring greater resilience in care delivery.

“All complaints are investigated to address patient concerns and enhance improved delivery.”

In April 2020, Forth Medical Group, which is also run by the same two doctors, took over three practices –Kersiebank in Grangemouth, Hallpark in Sauchie, and Bannockburn Medical Practice in Bannockburn, which had previously been run by Forth Valley NHS.

NHS Dumfries and Galloway said it could not discuss complaints due to patient confidentiality but added: “We take all patient complaints extremely seriously.

“The tendering process for both practices has been under way since Alba Medical Group informed NHS Dumfries and Galloway of its intention to vacate its contract, and no final decision has been announced regarding either practice.”

NHS Forth Valley said: “Any complaints regarding primary care contractors, including GP practices, would be dealt with via the practice’s complaints procedure to enable them to respond direct to any patient complaints or concerns individually.”

“If patients remain dissatisfied with the outcome of their complaint they can also contact the Scottish Public Services Ombudsman and ask for an independent review.”

A Scottish Government spokesperson said: “Patients who need to see a GP should always be seen and the Health Secretary has written to all GP practices to encourage them to ensure there is an appropriate mix of pre-booked, same-day, face-to-face and remote appointments.

“We aware of the specific situation with Lockerbie and Moffat. We are in discussion with NHS Dumfries and Galloway and expect all necessary arrangements are made to ensure patient disruption is minimised.”