Patients raise concerns about medical group as health board steps-up oversight

Patients at a Lanarkshire practice run by GP chain Alba Medical Group say unmanageably long patient lists and overstretched doctors mean they have been unable to make appointments, claiming lives have been put at risk as a result. 

NHS Lanarkshire is increasing its oversight of Woodstock surgery in Lanark and working on an improvement plan in response to the escalating complaints by both patients and local politicians.

Alba Medical Group currently runs seven practices across Scotland under various names including Lanark Medical Group, which runs the Woodstock surgery, in Lanark, as well as others in Strathaven and Coatbank. The GP group also runs surgeries in Bannockburn and Grangemouth under the name Forth Medical Practice, as well as practices in Erskine and Paisley.

The Ferret was contacted by patients in Lanark who said they have been unable to make appointments for weeks on end, even in health emergencies. One man, repeatedly unable to make an appointment, was later hospitalised and died three days later. 

Other patients claim they have struggled to access prescriptions or get referrals and several told The Ferret that their complaints went unheeded. A patient action group has formed and a public meeting is planned for Friday, 17 November, to raise ongoing concerns.

But Alba Medical Group, which took over the practice in July 2020, says many of the issues, such as those with GP recruitment, are inherited and entrenched due to the current GP crisis. The medical group insists it has made progress and is working hard to address problems. Complaints are taken seriously and addressed promptly, it added. 

Our treatment from the GP was just shocking.

Helen Tervit

The Woodstock surgery is a “multi-disciplinary practice” with a patient list of over 12,000. It had five temporary – or locum – GPs, making up the equivalent to 2.5 full time doctors, according to its own document dated September this year. They worked alongside nurse practitioners, a mental health nurse and a pharmacist.

But a spokesperson said recent recruitment of additional temporary GPs meant staffing levels were now equivalent to four full-time positions, along with additional nurses, part-time health care assistant and “physician associates” – healthcare workers who require doctor supervision.

Group partners Dr Usman Rehman and Dr Rameshwer Lal do not see patients there. The pair are also directors of a number of health related companies.

Alba Medical Group said though the practice understood some patients preferred seeing a GP, appointments with them were for the “most complex cases” in order to make “efficient use of resources”. 

NHS Lanarkshire confirmed it “recognised the concerns and frustrations of patients within Lanark” and said it had raised the issues with the Scottish Government. Alba Medical Group has “committed to delivering a detailed plan to improve patient access”, it added.

Local MSP, Máiri McAllan, welcomed the confirmation that health board oversight would be stepped up, claiming it was “crucial” that her constituents saw “urgent improvement” in the GP services offered.

But some patients told The Ferret the developments were too little, too late. They want to see the patient list closed, increased GP recruitment and greater transparency. Patients say they want their previous complaints to be properly addressed and insist they be allowed to move to a different GP practice line with the Scottish patient charter. 

Helen Tervit, whose brother died in May, said her family had been badly let down by the practice. On 26 May her brother started to complain of intense stomach pains and was vomiting. According to phone records, her mother called the practice eight times in the morning but was told there were no appointments available. Instead she was advised to go to the chemist to get anti-sickness medication.

She called again in the afternoon and was still unable to get her son seen. “Eventually she called an ambulance, which took seven hours to arrive,” says Tervit. Her brother was diagnosed with aspiration pneumonia and a blockage in his bowel and died three days later. 

“Our treatment from the GP was just shocking,” she said. “We can’t know what would have happened but he should have been seen. We’re angry.” Her mother sent a complaint to the GP who said they were looking into her case but then did not respond. She complained to the Ombudsman but its policy is only to investigate after a complaint process has been completed by the GP practice.

Tobias Nehn, who is disabled and has multiple sclerosis (MS), claimed that the practice repeatedly failed to return signed forms from providers of additional therapies necessary for his wellbeing, such as high dose oxygen therapy, which meant these could not go ahead. He has submitted complaints to the Lanark practice several times but his emails have gone unanswered.

“He described the referral system in the practice as “chaotic” adding: “In my experience primary health care is just not available here. I think the health board needs to step in.”

Stephen Haldane told The Ferret his ongoing concerns date back to last year when his wife, who was urgently in need of a prescription for her health condition, was unable to get the appointment needed to secure it. She later failed to get an appointment for “weeks on end”.

I can’t understand why nothing is being done by the Scottish Government to address what appears to be ongoing systemic failure.

Lisa Cameron, Conservative MP for East Kilbride, Strathaven and Lesmahagow

Haldane raised his concerns with Clydesdale MSP, Máiri McAllan but is frustrated and angry at the lack of progress. “None of the other practices in the area are anywhere near as under-resourced as Lanark, so why not redistribute patients to surrounding practices,” he said. “NHS Lanarkshire thinks it is acceptable to allow Woodstock to keep increasing its patient list despite the fact that they can not resource it.”

Alba Medical Group did not comment on the cases but said all complaints were investigated promptly and transparently. 

Last year Alba Medical Group handed back contracts for GPs practices in Lockerbie and Moffat to NHS Dumfries and Galloway, following numerous complaints by patients. The issue was raised in the Scottish Parliament by Oliver Mundell last September who claimed he had been “inundated” with concerns.

The Ferret has also previously reported on complaints about another Lanark Medical Group practice in Strathaven.

In the Scottish Government’s most recent health and care experience survey only 23 per cent of patients said they were satisfied with the care from Lanark Medical Group, the second lowest rating of any practice in Scotland. 

In the same survey only 11 per cent at the Lanark Medical practice were positive about arrangements to speak to a GP, versus 50 percent of those in the Clydesdale cluster of GP practices. 

However Alba Medical Group confirmed it has since carried out its own survey of 1,557 patients in which 70 per cent said they were “very satisfied” with getting through to the practice and “96-99 per cent” said they were “very satisfied” with the clinician they saw.

It is understood the paper survey was given to patients who had face-to-face appointments. The survey’s full results were not shared with The Ferret.

But Conservative MP for East Kilbride, Strathaven and Lesmahagow Lisa Cameron, said the situation remained “dire” for many of her constituents in relation to complaints about Alba Medical Group.

“I have weekly cases to raise that are extremely clinically concerning and NHS Lanarkshire are aware I now have a caseworker assigned purely to this practice due to the volume of issues raised,” she said. “I can’t understand why nothing is being done by the Scottish Government to address what appears to be ongoing systemic failure.”

Jackie Baillie, Scottish Labour’s health spokesperson, added: “This is an incredibly worrying situation that must be remedied as soon as possible.

“We cannot have the people of Scotland going without medical care due to years of SNP cuts to primary care. We need action now to bolster primary care and to deliver the care that the people of Scotland deserve.”

Clydesdale MSP McAllan said she had been “campaigning determinedly for improvements” on behalf of constituents since she was elected in May 2021.

She claimed that “after months of disappointing progress” she had a “breakthrough” in September when NHS Lanarkshire “answered my call to come to Lanark and see for themselves what constituents were experiencing at Woodstock”.

“I think it was clear to NHS Lanarkshire that there were problems in service provision and so I immediately called for urgent improvements,” she added. An improvement plan is being developed and the frequency of oversight meetings by the health board increased from quarterly to month.

“This work must be completed rapidly and thoroughly,” McAllan added. “It will be vital for the Lanark community to be engaged and, most of all, crucial that they see urgent improvements in their experience as patients.”

None of the other practices in the area are anywhere near as under-resourced as Lanark, so why not redistribute patients to surrounding practices.

Stephen Haldane

Professor Soumen Sengupta, director of health and social care at NHS Lanarkshire, confirmed the health board had raised its concerns with Alba Medical Group and would be increasing oversight and said he recognised “the concerns and frustrations of patients within Lanark”.

“Alba Medical Group has committed to delivering a detailed plan to improve patient access in Lanark,” he added. “We continue to engage with Alba Medical Group and have reinforced the importance of their access plan being progressed in a transparent manner. We have also highlighted the issues and challenges in Lanark to the Scottish Government.”

However GP recruitment – both in Lanark and across Scotland – was a “longstanding difficulty”, Sengupta admitted. The problem has been repeatedly highlighted by the British Medical Association (BMA).

Lisa Johnstone, group operations director for Alba Medical Group, said: “Despite the national shortages and geographical challenges facing areas such as Lanark, we have actively recruited GPs and expanded our multi-disciplinary team to address the needs of our patients. While we understand some patients may prefer seeing a GP, our model allows us to direct the most complex cases to GPs, ensuring efficient use of our resources.”

She said the group “valued patient feedback” and had “an active and engaged Patient Participation Group, which is helping shape services for the community”. “We are also working on improving access, including exploring I.T.-based access methods and collaborating with our Telecoms provider to improve phone access,” she continued. 

“We welcome collaboration and are committed to working closely with the Lanarkshire Health Board to enhance our services and address the concerns raised by our patients.”

She declined to comment on the specific complaints raised by The Ferret “due to confidentiality issues” but added: “We take all patient complaints seriously, conduct thorough and transparent investigations…and strive to provide the best possible care to all our patients.”

Main image: GuindillayPimienta/iStock

This Ferret story was also published with the Herald. Our partnerships with other media help us reach new audiences and become more sustainable as a media co-op.  Join us to read all our stories and tell us what we should investigate next.