30 Nov 2015
Area of work:

Primary care is facing unprecedented demand to find new ways to deliver care – with an increased emphasis on managing population out-of-hospital through a focus on improved prevention, access and quality of care. All the while, spending on general practice has fallen or flat-lined for the past five years. Collaborative working – including the formation of federations and networks within general practice – is at the heart of overcoming these challenges.  


The Royal College of General Practitioners and the Nuffield Trust were commissioned by NHS England to examine the landscape of scaled-up general practice and to develop an online network to support new and emerging collaborations.

This slide pack presents the results of two online surveys which aimed to examine the landscape of collaboration in general practice: one distributed to general practitioners (GPs); and the other distributed to clinical commissioning groups (CCGs).

The surveys were undertaken from July to November 2015 and aimed to provide a snapshot of the pace and scale of large-scale collaboration in general practice in England. They include responses from 94 CCGs and 982 GPs and practice representatives.

Key findings include:

  • The majority of GP respondents (73 per cent) report being part of a formal (37 per cent) or an informal collaboration (26 per cent) and the numbers are growing rapidly – 44 per cent of respondents say that their collaborations formed in the last year.

  • GPs and CCGs report that the growth in collaborative working is driven primarily by CCG encouragement alongside financial pressures faced within general practice and a desire to expand the range of services offered in primary care.

  • Extracting the full benefits of collaborative working between practices can take time despite having clear vision and motivation – at least two years for many GP collaborations.

  • To further develop collaborative working, GPs and CCGs are seeking support for organisational and leadership development, as well as legal advice.

The survey results will be used to inform the RCGP online learning network, which will launch on 1 December as part of the Supporting Federations programme. The Nuffield Trust will be providing a number of resources to support the network over the coming months.

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