Managing change in the NHS | Starting new GP services in Scotland at a time like this?

We can all agree this may not be the best time to make big changes to the way we do things. Circumstances are, to say the least, challenging. Managing change in the NHS during the Covid pandemic surely comes with additional hurdles? So how did NHS Forth Valley get on transferring three 2C GP practices from Health Board management back into independent control?

It turns out the answer is “very well”. 

The transfer happened smoothly on the 1st of May after several months of detailed preparation. Despite the Covid-19 crisis, Health Board staff, the new providers and At Scale’s team worked together to ensure continuity of services to patients at Grangemouth, Sauchie and Bannockburn, a combined list size of nearly 22,000. The Health Board took over the management of three practices after several GPs left or retired. Following an open, competitive tendering exercise, a group of local GPs took over the running of the three Forth Valley 2C practices.

The award was announced back in January 2020. NHS Forth Valley Associate Medical Director for Primary Care, Dr Stuart Cumming, said: “Transferring the management of these three Practices to GPs is a very positive development which will bring them back into line with the arrangements in place in other Medical Practices across Forth Valley.” The Health Board were keen the decision provided the basis for long-term practice sustainability, continuity of care for local patients and released resources which could be reinvested by the Health Board to develop local services.

Since the Health Board’s decision, much work has gone into making sure patients, stakeholders and staff were all kept fully informed about the transfer. There was a lot of activity undertaken to make sure everyone understood the detail of the transferring processes and systems and not least, to make sure there was sensitivity in handling the TUPE transfer of nearly 50 staff from the Health Board to the new providers. The Board’s HR team played a crucial role in making sure the TUPE process went as smoothly as it could. Following the transfer on the 1st of May, Care, Dr Cumming thought there has been a collective sigh of relief from the Health Board and the new providers. “The date came and went uneventfully” said Dr Cumming. The new providers are now working on transforming the way services are provided and looking forward to a time when things return to something like normal for the three practices.

The Health Board Forth undertook a competitive tendering exercise for the General Medical Services (GMS) Contracts to run the three 2C Practices. At Scale supported the successful Scottish GP group prepare the tender and mobilise the contract. The successful bid provided responses to the Health Board’s range of criteria including the quality of future patient services, resilience and sustainability of proposed service and clinical staffing arrangements contract and performance management experience, governance and approach to community-focused multi-agency working.

At Scale’s consultancy and support offers tailored advice and support to GP practices in Scotland and England in managing change in the NHS during the Covid pandemic and those seeking to improve and develop their services and workforce, hand in hand with maximising digital transformation. At Scale have helped other GP practices with similar projects and have worked with practices change the way they operate and become more resilient.

At Scale work with GP practices across Scotland and England come together and implement more efficient ways of working by managing change in the NHS. If you think that’s something your practice needs, drop an email to and he will be happy to chat with you. And find out a little more information about NHS Forth Valley’s 2C practice tender, click here