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Federations: policy pipe-dream or the future for GPs?

Are federations the future? Our splash last week on the joint RCGP-BMA document which argues, in no uncertain terms, that they are, has attracted a fair amount of comment from GPs.

By Steve Nowottny

Are federations the future? Our splash last week on the joint RCGP-BMA document which argues, in no uncertain terms, that they are, has attracted a fair amount of comment from GPs.

Some have backed the plans, warning they're long overdue – others fear they herald the beginning of the end for independent contractors, and a slow descent into a salaried service.

This week, I've been working on an in-depth feature on what exactly a federated future for general practice might look like. As you'll be able to read, in a number of areas federations in some form are up and running already, and doing all sorts of exciting things around shared back-office functions and redesigning clinical pathways.

But it was only when I spoke to Dr Michelle Drage, joint chief executive of Londonwide LMCs, that the true scale of the task facing the RCGP and BMA emerged.

London is, you'll remember, where Lord Darzi's polyclinics were first unleashed, and where federations of GPs are supposed to be the answer. In Camden, for instance, plans for a 50,000-patient polyclinic have been dropped in favour of federated schemes.

But even in the capital, it seems, federations have a way to go before they're ready to challenge polyclinics. After talking through the benefits of the model, as a final question I asked Dr Drage: so, are any up and running yet?

‘Well… no,' she replied. ‘That's a very good question. We're all very good at talking about them, but I don't think anyone's really got anything up and running at the level that would fit the bill.

‘We're working on it.'

Turning the vision into reality, if it happens at all, is going to be a long, hard slog.

RCGP RCGP

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