17 Jun 2015
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In this briefing, we examine the approaches and levers for change that can be utilised by policy-makers and regulators to promote change in general practice.

In this video short, Dr Rebecca Rosen gives a quick overview of her new briefing 'Transforming general practice: what are the levers for change?'.


The current model of general practice is largely considered to be in need of reform. Through national policies including NHS England’s Five Year Forward View and the Prime Minister’s Challenge Fund, there has been a significant focus on transforming the sector through scaled up networks; federations and super partnerships of GPs and upskilling the workforce to deliver change.

As a consequence, general practice is under immense strain as they are expected to deliver these changes, implement new models of care and take more care into the community.

Transforming general practice: what are the levers for change? examines academic evidence on current methods of driving change, as well as expert testimonials and case studies, to present a series of recommendations on how policy makers and regulators can support general practice to deliver these changes.

The briefing argues that financial rewards, which are currently used to incentivise small scale changes by the Quality and Outcomes Framework (QOF), are at risk of being overused and are not the best way to encourage widespread reform in general practice.

The history of reforming general practice in England is littered with initiatives aimed at achieving small-scale change through financial rewards. These can work well if the goal is to improve narrow areas of care. But they are blunt instruments, which can distort priorities and detract from patient care.

Dr Rebecca Rosen, briefing author

Instead, the briefing argues that in order for this radical transformation to succeed, time should be devoted to developing new skills and working practices across the whole GP workforce, investing properly in equipping organisations to change and ensuring that better data is available to evaluate impact.

To support this publication, we also produced a brief review of literature on methods for supporting change in general practice and primary care


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