Independent Practitioner Associations in New Zealand: surviving to thrive

^{John Macaskill-Smith, Chief Executive Officer of Midlands Health Network, on his experience of GP-owned networks and efforts to build integrated care.}

Primary care based physician groups are the focus of much policy interest worldwide as a potential vehicle for more community-based care for people with long-term conditions. All health systems face cost pressures, and are looking for ways to develop integrated care that is less dependent on high-cost hospital inpatient services. The coalition government’s plan to devolve commissioning to groups of clinicians in the English NHS has reignited interest in the potential of doctor-led purchasing and provision of care from a primary care perspective.

Our analysis of the New Zealand experience of giving budgets to autonomous physician groups will highlight the potential benefits and pitfalls associated with this approach

Physician groups have already developed in a number of countries, including the US, Australia, New Zealand and Canada.

This project analyses the development of primary care-based physician groups in New Zealand, where there is a long standing network of independent practitioner associations (IPAs).

We will document the history and experience of IPAs in New Zealand, assess their achievements, examine the factors that enabled and inhibited the progress and achievements of the IPAs, and consider their next steps in New Zealand in the context of international interest in the development of integrated care. We plan to publish a report in 2012.

This project will have strong relevance to policy-makers and practitioners in the UK as they set about examining the potential of groups of clinicians acting as both commissioners and providers, and as a means to change the relationship between primary and secondary care for the benefit of patients.

Our research will highlight both the potential and pitfalls associated with this way of planning, funding and delivering services within a health system.