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GPs go forth

GPs discussing 540,000-patient mega-partnership

One of England’s largest GP federations is contemplating a merger that could create a 540,000-patient mega-partnership.

The Suffolk GP Federation, which currently consists of 58 separate GP partnerships, is looking at ‘different options’ for taking their collaboration forward, including one mega-partnership or several super-partnerships with more than 100,000 patients each.

Its chief executive David Pannell said one option being looked at also includes a model where GPs would become salaried to the new entity or entities.

He said the work, which could potentially create the largest super-practice yet, is being fuelled by a bid to alleviate pressure on individual practices.

He said: ’We are discussing seven different options, which include the formation of super-practices, pursuing a salaried model and practices merging. We have been in discussions for about a year and expect to put out something about the findings of the talks in the next couple of months.

’It’s up to the practices themselves if they want to go forward with the super-partnership option and in what form. There are lots of possible permutations.’

Super-practices have increased in number as GPs look to change their models to cope with increasing pressures on the system.

But the previously two largest super-practices to emerge – both formed last year – were the 275,000-patient Our Health Partnership and the 100,000-patient Lakeside Healthcare.

Mr Pannell said that while the number of super-partnerships was increasing, relatively little was known about how they worked and what benefits they could bring.

He said: ‘Many salaried GPs don’t want to become partners because they don’t want to take on the liability of owning a building. Super-practices can be set up so that GPs can become partners without having to take on building ownership.

‘Super-partnerships can also take on more work which is being pushed out of hospitals and serve entire populations. It’s difficult for GPs to have a voice at the table on policy discussions and the like – super-practices can give them more of a voice.’

It comes as NHS England’s primary care commissioning lead Dr David Geddes announced plans at a conference earlier this month to merge his small York practice with another local service to create a 44,000 patient super-practice.

The Suffolk GP Federation is run as a not-for-profit community interest company and serves 540,000 patients across rural Suffolk and Ipswich.

The rise of the super-practice

Industrial-scale GP services have started to emerge, including the 100,000 patient, 62 partner practice at Lakeside Healthcare and the gigantic Our Health Partnership in Birmingham and Sutton Coldfield, which involves 200 GP partners and a list of 275,000 patients.

Merging of practices into super-practices is a trend unlikely to abate, with it the option being almost universally floated as the holy grail to make GP services sustainable.

The Government has mandated NHS England to ensure half of England’s population is covered by one of the new GP care models by 2020 - typically larger practices providing both primary and secondary care - and the GPC’s blueprint for the future of general practice also focused on working ‘at scale’.

NHS England is also developing the Prime Minister’s new voluntary Multidisciplinary Community Partnership (MCP) GP contract during 2016, to be rolled out for practices with at least 30,000 patients, and delivering seven-day access, from April 2017.



Readers' comments (18)

  • I can understand the savings in backroom tasks but fundamentally we have a shortage of FTE GPs and too much demand on them by the great British public. Federate all you like but it comes down to that. Basically we are screwed.

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  • Super partnership!!!

    540 000 patients!! empire building

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  • Soone there will be Primary care hospitals as well as secondary care hospitals. Could potentially be a good thing. Keeping an open mind here. It will probably be a massive disaster though.

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  • How about a 39,000 partner/65,000,000 patient super-duper mega practice. I hereby submit a tender for about £12Bn per year.

    Over to you, Jezza.

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  • Big is not beautiful and will only make care worse, more disjointed and likely to lead to more complaints and harm. Why listen to common sense when you can just make up the stats as you go along?

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  • Vinci Ho

    As I said before, one CCG , one super/mega-partnership . Really?
    Feasible , practical and financially stable ?
    May be the tide is too high.....

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  • It's general practice Jim, but not as I know it (nor want to).
    I am well aware of the distorting effect that getting older and more stressed can have on one's perpective but I have to worry that bigger is not better, and in fact beyond a certain point is likely to be worse. And if general practice tends to become worse then the arguments of those who want to dismantle it altogether will become stronger. Generally speaking it is not because general practice is inefficient that it is going to the wall (cf international comparisons) it is because of inadequate funding. Further reorganisation and corporatisation of practices is likely only to accelerate the stampede for the exit and hasten the end for the jewel in the crown of the NHS. Think very carefully.

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  • It's all bollocks .

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  • The mega-partnership has one purpose - to be easy for Boots/United Health et al, to take over. That's why Cameron and Hunt want it. And that's why GPs are so gullible to be going along with it.

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  • Just getting silly - that's not general practice but at least using a term other than "super" when it isn't. What's next? Titanic-practice covering the whole country?

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