General practice and primary care are under considerable pressure to change and improve. The traditional model of small GP surgeries is widely considered to be no longer fit for purpose and pressure is on to ‘scale up’ general practice through networks, federations and super-partnerships. According to NHS England’s Five Year Forward View, GPs will need to operate at scale and upskill significantly in the future.
Highly publicised problems with access to GP appointments and in some cases, breaches of quality standards in general practice have resulted in numerous policies and initiatives to improve care. To date, a number of methods have been tried in order to change GP behaviour and improve the quality of care. These include the use of financial incentives, changes to the GP contract, education and development programmes, regulation and organisational development funds. However, perhaps the most commonly used approach is payment of financial micro incentives, linked to delivery of a specified process our outcomes.
At this seminar, organised in partnership with NHS England and with support from EY, we explored the range of mechanisms currently used to drive change in general practice, examine the strengths and weaknesses of different approaches and consider how to balance the use of different change mechanisms to support the transformation of general practice and primary care.
Some of the questions we explored:
- Have we become too dependent on financial micro-incentives linked to specific performance measures as a lever for change?
- Do we need to re-balance the ways in which we seek to drive and support change?
- What combination of approaches will best support general practice and wider primary care providers to deliver excellent care?
- What will be the barriers to change that policy makers need to avoid?