An independent investigation has found the closure of a specialist GP service for people experiencing homelessness in Glasgow was mishandled, with health leaders accused of acting in haste, failing to consult staff, and showing a lack of understanding of vulnerable patients’ needs.

The Independent National Whistleblowing Officer has upheld all whistleblowing complaints around the closure of the Hunter Street practice.

Seen as a ‘vital safety net’ for those experiencing homelessness in the city, the Hunter Street Health service was closed in March 2023 during service reorganisation.

The service provided specialist and coordinated primary care alongside outreach and work to link people to wider services.

The Whistleblowing Officer says in its findings Glasgow City Health and Social Care Partnership (HSCP) ‘unreasonably failed’ to meaningfully consult staff and the wider community when making its decision.

It also states in its report the HSCP failed to take action to address the long-term risks associated with a reduction in specialist GP service provision, while leaders lacked transparency throughout the process.

This includes failure to deliver an equalities impact assessment or consider potential ‘significant’ ongoing negative impact on access to primary care for people experiencing homelessness.

The Whistleblowing Officer also identifies faults in the review conducted by NHS Greater Glasgow and Clyde around whistleblowing concerns raised to the health board about the HSCP’s failures, writing:

‘I am surprised that this was not identified by the board during their own handling of the whistleblowing concern.

‘This strongly suggests there is a need for more staff training to ensure that decision makers and staff involved in service change are aware of the organisation’s responsibilities.’

‘Abandoned’ standards and ‘rushed’ closure

The investigation heard that the HSCP organised three workshops with GPs from the service, to collaborate on a review of the model of delivery and understand the potential patient impact.

Despite initial intentions, the Whistleblowing Officer found that service review outline shared with staff was ‘abandoned’ after the HSCP deemed it ‘unnecessary’.

The decision to close the service was found to have been taken by health leaders ‘very quickly’ – noting that the final workshop with GPs appears to have occurred ‘after a decision had effectively been made’.

Only a week before the closure took place, the ‘rushed and hastily rolled out’ decision did not was neither informed by or communicated properly to staff or patients.

The Scottish Deep End group of clinicians from general practices caring for Scotland’s most socioeconomically disadvantaged communities welcomed the report’s findings and recommendations.

Responding to the news, the group told healthandcare.scot that GPs remain committed to improving care, and urged leaders to consider the reinstatement of the homelessness health service:

“We are keen to support a positive way forward to ensure there is high quality primary care available for Inclusion Health populations (including people experiencing homelessness) in Glasgow and throughout Scotland. 

“In particular, we agree with the report recommendation that ‘the ongoing health needs of those experiencing homelessness are understood and services adjusted as required’. 

“This health needs assessment needs to be rigorous, and involve all relevant stakeholders, in a way that builds trust.

“We believe that the reinstatement of the specialist general practice should be considered as an option to ensure the provision of flexible, inclusive, tailored healthcare for people experiencing homelessness.”

The report recommends Glasgow City HSCP improve the way it assesses health needs and makes decisions around services.

The Whistleblowing Officer will review progress in June and October 2025.

Responding to the report, a spokesperson for Glasgow City HSCP told healthandcare.scot:

“We note the findings of this report and as a continuous learning and improving organisation will take time to consider the recommendations. 

“In terms of our current homelessness provision, we have in place well-established governance arrangements and continue to develop services for those impacted by homelessness despite increased demand and a challenging financial climate.”

NHS Greater Glasgow and Clyde has refused to comment, telling healthandcare.scot that it won’t add anything to the HSCP’s comment. 

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