Closure of Glasgow homeless GP service ' very worrying'

Members of the Deep End GP group, which represents practices based in the 100 most deprived areas of Scotland, said they were going public with their concerns as a "last resort" after appeals to Glasgow's health and social care partnership (HSCP) failed, reports our sister title The Herald.

The Hunter Street practice in the Gallowgate area of the city closed on March 31 as part of a reorganisation of the Complex Needs Service (CNS), which shares the premises.

The three GPs who had previously run the specialist practice for the homeless as a standalone service have been incorporated into the CNS.

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The HSCP says this forms part of a drive to "focus on people at the highest risk of premature mortality" and insists that the 100-odd patients who used the specialist homeless service - most of whom are in temporary accommodation, rather than rough sleepers - are now registered with GPs closer to where they stay.

However, Deep End GPs argue that this comes at a time when mainstream general practice is already severely overstretched.

Of the 100 Deep End practices in Scotland, 70 are based in Glasgow.

The HSCP said patients who had used the specialist service at Hunter Street were mostly in temporary accommodation rather than rough sleepers (Image: PA)

In a statement, 'GPs at the Deep End' said: "The many clinical teams in the city who support people experiencing homelessness including Emergency Department colleagues are very worried.

"Furthermore, this is happening during a cost-of-living crisis and at a time when mainstream general practice is already in a precarious state and unlikely to be able to adequately meet the often-complex needs of this patient population.

"The importance of a dedicated specialist service is perhaps greater now than ever before.

"We know of many patients who have been adversely affected by this already, including not being able to get vital medication, or fit notes so they can access benefits."

They said the decision had been taken "without assessing what risk this brings for individual patients or for the professional teams in health and social care who rely on this practice as a safety net", and leaves Glasgow as an outlier despite having "far and away the most people experiencing homelessness".

Edinburgh has a specialist GP practice for the homeless which is run by the health board, and similar services on a smaller scale are in place in Aberdeen and Ayrshire.

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Official guidance stipulates that health and social care for people experiencing homelessness should be based on an assessment of the "quality and capacity of existing mainstream and specialist service provision".

The Deep End GPs said the closure of the specialist service at Hunter Street "flies in the face of this guidance and we are seeking a reversal of this decision".

They added: "Having previously tried without success to formally make the case to the Glasgow City HSCP that this decision will have significant negative consequences for our patients, we are now making our concerns public as a last resort."

The Queens Nursing Institute Scotland, a charity promoting high-quality nursing in the community and which works with Deep End GPs, said the closure "is likely to further exacerbate existing health inequalities" for homeless people and backed calls to reverse the decision.

Carey Lunan, chair of the Deep End GP group (Image: Angela Catlin)

The HSCP said an equality and diversity impact assessment is currently underway and will be completed within three months of the service change "in line with NHS guidance". 

It said that a consultation on changes to the Complex Needs Service began in November 2021, including input from people with lived experience of homelessness and addiction. 

In a statement, Glasgow HSCP said: "Most people experiencing homelessness and complex needs in Glasgow City are registered and receiving care from local GP practices and the Complex Needs Service is designed to work with community services, keeping people in their local areas, to support their integration into communities.

"The GP element of the CNS will no longer function as a standalone practice containing only GPs, but will instead focus on people at the highest risk of premature mortality.

"The enhanced CNS will now also provide an urgent care and bridging service to ensure that vulnerable people can access urgent care in the community and can get support to register with a practice where they are living."

Pat Togher (Image: HSCP)

Pat Togher, Assistant Chief Officer for the HSCP said: "I look forward to joined up working across the whole service, wider HSCP, community-based services, third sector colleagues and those with lived experience to improve outcomes for the most vulnerable people in Glasgow."