Large-scale general practice – can we rise to the challenge?

Across the country, traditional general practices are grouping together into larger organisations. For some this is a strategic move following years of collaboration. For others it is a defensive response to financial pressures, workforce crises and the threat of takeover. 

The Five Year Forward View envisages some of these organisations at the heart of the new models of care programme. Whether as networks, federations, super-partnerships or multi-site organisations, the assumption is that large GP groups will be more sustainable than small practices; better able to improve quality, reduce variations and ready to work with other providers to transform care. But what is the evidence for these assumptions?  And what can emerging scaled up organisations learn from those established?

This Nuffield Trust one-day national conference, in collaboration with the National Association of Primary Care, New NHS Alliance and the Royal College of General Practitioners (RCGP), brought together national policy leaders, managers and practitioners on large-scale general practice to help fill this evidence gap, explore the challenges these emerging large-scale organisations face and share ideas regarding which approaches are successful.

With speakers from the RCGP, NHS England and large-scale GP organisations across the country, the conference explored the following:

• The impact of the policy and financial context on the current state of general practice: what opportunity does scaling up offer?
• What can we learn from New Zealand’s experience of larger general practice organisations?
• Sharing innovations and ideas from emerging and established large-scale organisations: practical lessons and approaches to succeed at-scale
• The dual purpose of large-scale general practice organisations: future expectations for practices and GP leaders to do more and deliver improved care.

The Nuffield Trust also presented some emerging practical lessons from an 18-month study of large-scale general practice organisations, published in July 2016, exploring their impact on sustainability, patient experience and staff satisfaction