I totally agree with Michael Crow. I mark significant events and it is remarkable how many are due to lack of continuity in large practices. I work many extra hours doing paperwork, running the practice etc. If I was salaried in a large practice I would be leaving on the dot. The health board will be surprised how much it will cost to run the NHS. If I'm employing a plumber or builder I would always choose a small business over a large company. I'm sure the personal service offered by small practices outweighs any supposed economies of scale.
I'm shocked at the lackadaisical attitude of the previous comments. I have already constructed an avatar of myself to be provided to all patients on my demise. It is available as an app. My avatar nods politely, asks what the patient thinks is wrong then offers sympathy, advises to drink plenty of fluids and rest.
Change is certainly easier to effect in small practices. The way ahead for general practice should not be supersized surgeries and conglomerates. A great achievement!