Primary care for the 21st century: learning from New Zealand's independent practitioner associations

This report offers insights from the experience of organised general practice in New Zealand.

John Macaskill-Smith, Chief Executive of the Midlands Health Network, discusses the development of integrated care in New Zealand.

Over the past two decades, many GPs and other primary care clinicians in New Zealand have worked collaboratively in independent practitioner associations (IPAs). These networks of primary care providers developed in the early 1990s from the grassroots of general practice.

Although IPAs have not held budgets on the scale of that planned for clinical commissioning groups (CCGs) in England under the Health and Social Care Act 2012, they nevertheless demonstrate the significant potential of organised general practice to enable innovation and expansion in the local provision of care, and to help in the development of more integrated services.

New primary care networks may be the most enduring legacy of clinical commissioning groups. These groups may well gain from exploring how to stimulate new provider networks, based on New Zealand's experience  Co-author and Nuffield Trust Senior Fellow, Ruth Thorlby

Primary care for the 21st century: learning from New Zealand’s independent practitioner associations, by Ruth ThorlbyDr Judith Smith, Professor Pauline Barnett and Professor Nicholas Mays, is based on a series of in-depth interviews with IPA leaders, senior policy-makers and health officials in New Zealand who have all been closely involved with IPAs since the early 1990s.

The report was supplemented by previous research on IPAs, and on analysis of documents related to the development, operation and evaluation of organised general practice.

The authors' findings include:

  • clinical commissioning groups may need to form wider networks to secure the active engagement of GPs;
  • giving GPs genuine (not just on paper) independence is critical;
  • public health does not currently appear to be a natural priority for GP groups, so time and support will be needed to allow them to develop in this area of their work.

This research report forms part of the Nuffield Trust project: Independent practitioner associations in New Zealand: surviving to thrive. Visit the dedicated project page for additional resources including blogs and video interviews with international health leaders.

Suggested citation

Thorlby R, Smith J, Barnett P and Mays N (2012) Primary care for the 21st century: learning from New Zealand's independent practitioner associations. Research report. Nuffield Trust.