Working at scale in collaborative arrangements is widely accepted as the future of general practice. In 2015, the Nuffield Trust and the Royal College of General Practitioners (RCGP) published the results of two surveys. This survey found that 73% of practices were already operating in collaborations and were motivated to do so by financial pressures, a desire to expand the range of services offered, and CCG encouragement.
In 2017, we conducted a further two surveys, sent to general practice staff and to CCG staff, that aimed to find out what had changed in the landscape of general practice and to explore what GPs feel the future holds for them.
These surveys were conducted as part of the RCGP and Nuffield Trust’s ‘General Practice at Scale’ programme. This slide pack brings together the responses from 565 GP practice staff and 51 CCG staff.
Key findings include:
- The scaling up of general practice continues apace with 81% of general practice-based respondents reporting that they were part of a formal or informal collaboration, up from 73% in 2015.
- However, the landscape is complex. Practices often belong to multiple collaborations that operate at different levels in the system, having been set up to fulfil different purposes.
- The main priorities of all collaborations over the last year were: increasing access for patients, improving sustainability, and shifting services into the community. The priorities differed by size of collaboration. Both providers and commissioners reported that time and work pressures were the biggest challenge to collaborations achieving their aims.
- When asked about developments in their local area, over half of GP staff and one-third of CCG staff surveyed felt practices and collaborations had not been at all influential in shaping the local sustainability and transformation partnership (STP). Only one-fifth of GPs thought STPs would deliver meaningful change in primary care. CCGs were more optimistic, with 61% reporting that meaningful change was probable.
- When questioned about future models of care, around half of practice partners (53%) said they would be 'unwilling' or 'very unwilling' to give up their current GMS/PMS/APMS contract1 to join a new models contract (e.g. MCP or PACS contract2). The most common reason they gave was that they did not want to lose control of decision-making and leadership in their practice.
1. General Medical Services (GMS)/Personal Medical Services (PMS)/Alternative Provider Medical Services contract
2. Multispecialty Community Provider (MCP) or Primary and Acute Care System (PACS) contract
Kumpunen, S. Curry, N. Farnworth, M. Rosen, R. (2017) "Collaboration in general practice: Surveys of GP practice and clinical commissioning groups" Nuffield Trust, Royal College of General Practitioners survey www.nuffieldtrust.org.uk/research/collaboration-in-general-practice-surveys-of-gp-practice-and-clinical-commissioning-groups