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GP practice numbers could go from 7,500 'to 1,500 super hubs', minister says

David Mowat, the junior health minister responsible for general practice, has said that the current 7,500 GP practices in England may reduce to just 1,500 in future.

He said that this comes as they are ‘finding that it is working better’ for GP practices to have lists of 35,000-40,000 patients, and that therefore they were 'migrating over a period of time' towards the model.

Mr Mowat was speaking in a Westminster Hall debate about the rising cost of GP indemnity when he was asked what the future model of general practice may look like.

He responded: 'Increasingly across the country… we are finding that it’s working better by putting GP practices into hubs of 35,000-40,000 people, where they are able to employ pharmacists, to employ physios, to do more things at scale than perhaps they would be able to do just in a single practice… with two or three GPs, which is historically what has been the case.

'So we are sort of migrating over a period of time to a position in which there may be - well, there are 7,500 GP practices around the country - to something more like 1,500 of these sort of super hubs.'

But he added that it would be 'a long road' until this became a reality, due to the time it is taking to roll out a new contractual model.

He said: 'Although it is also true to say that the contract position hasn’t caught up with that, and that is a long road.'

The news comes as the Government's new 'voluntary' contract for multispecialty community providers (MCP) - the new GP model covering lists of at least 30,000 patients - has run into delays with none of the six pilot areas around the country set to actually go live with their contracts from next month as was originally planned.

It also comes as the Department of Health has mandated NHS England to ensure that half of the country is covered by the new care models by 2020.

And even the GPC has said in its vision for the future of general practice that super-practices could be one of the few ways of ensuring the ‘core principles’ of general practice are retained.

But the GPC is fighting for practices to be able to keep the GMS contract alongside the new contract, and has advised practices not to feel pressured to ditch their current contracts to enter new models.

The Government has previously said practices on the MCP contract would provide seven-day access, but as Pulse recently revealed at least one of the pilot areas has silently ditched that element.

Little has been revealed about what will actually be asked of practices on the new contract, except that funding will be linked to outcomes. This is expected to include funding decreasing if they fail to reduce hospital admissions.

Pulse predicted the rise of the super practice as early as two years ago, as average list sizes had already risen by 28% between 2002 and 2015.

Readers' comments (30)

  • Who thinks that larger practices will reduce admissions?

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  • Not me 5.31.More likley the number of GPs will fall to 1500 by the time this lot a finished chewing up and spitting out the medical profession.

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  • Believe it or not if I were a young GP I'd be looking for a good partnership right now. The junior and senior partner model is coming very soon.

    This doctor-lite model could mean that the ladder could be pulled up in a big way.

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  • super hubs? don't we call those hospitals?

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  • The march of the federation.

    the answer without any questions!

    The model will truly be of supervising senior partners and then shift workers of various types who can work whatever pattern suits them.

    Truly scary and designed by accountants and NHSE!

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  • Forgive Mr Mowat, he is a politician and knows not what he does..
    the only migration going on is toward retirement or another country ..
    the UK public had better get used to the idea that they won't have a general practice service in 5 years time

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  • Of course bigger units that are hospital sized are more efficient and cost effective!They wont be overspent and unable to recruit.They wont be top heavy with management and admin.They wont need bailing out.But they will be too big to fail.Imagine a 'Big Hub' failure.You wont be able to hide that one unlike the current failure of our corner shops.This is so sad.

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  • Only 12 more working days left. These units will be taken over by the acute trusts. Bye bye traditional general practice in fact bye bye general practice

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  • Vinci Ho

    ' This is expected to include funding decreasing if they fail to reduce hospital admissions.'
    This will be the details in the devil: you will have to get even bigger until hospital admission is reduced , otherwise less funding . The figure of 15,00 is not going to be far away then!

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  • I suspect these super practices have higher admission rates due to lack of continuity of care

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