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A faulty production line

A super-partnership helps us adapt for the future

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Within each cell of the human body there are a multitude of tiny organelles. These compartmentalised functional parts are enclosed and the cells that form solid organs group together. The organs are then co-ordinated themselves within the body. It’s almost like the armed forces. Individual soldiers are part of battalions or regiments, which are in turn part of brigades. An individual soldier is nowhere near as effective as a group of like-minded ones.

When the NHS was first created in 1948, general practitioners elected to remain as independent practitioners. The majority of GPs were single handed, working on their own, but as medicine, contracts and conditions evolved it became more attractive for GPs to form partnerships with each other.

There are still highly autonomous GPs who work singlehandedly, providing their patients with unrivaled continuity of care, one of the most valuable cornerstones of effective general practice. Some GP surgeries try to maintain this continuity by having personal lists within a partnership. Though this can perhaps only work best with those that work for increasingly unfashionable full time hours in order to give their patients enough access. Overall, though, the vast majority of GP partners work in partnership with others. Over recent years it seems to be a viable option to meeting the demands of patients, central contracts, regulation and local bureaucracy.

Our Health Partnership provides a potential mechanism for adapting to new ways of working on the horizon

If GP partnerships are the organs made up of cellular GP partners, or the battalions of the front line primary care foot soldiers, then larger GP networks are the ‘higher order’ organisations of the body and brigades for the respective analogies. Many would argue that the conditions and demands of working in general practice will necessitate, sooner or later, the consideration of forming larger organisations, such as federations, super-practices and super-partnerships.

And to that end the UK’s biggest super-partnership, Our Health Partnership, recently presented its newly elected management board, its hope and vision to a good proportion of its 149 partners, from 32 practices across the Midlands. In a period of just nine months we have constructed a legal and financial framework to create an overarching partnership that covers 275,000 patients, with the aim of maintaining and improving the standard of care for our patients, with each practice retaining its own personal list.

Stirring speeches on the night by Prof Chris Ham of the King’s Fund and GPC Chair Dr Chand Nagpaul reminded us that the aim of Our Health Partnership is not to make savings through working at scale, though it can only function if it does this, but that it provides a potential mechanism for adapting to new ways of working on the horizon and mechanisms for improving the working conditions of our staff through the solidarity of sharing the burden bureaucracy and regulation.

Dr Samir Dawlatly is a GP in Birmingham, managing partner and board member of Our Health Partnership and co-clinical director of QCAPS Referral Improvement Programme

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Readers' comments (12)

  • Vinci Ho

    Very aware of the arguments for and against this. As you said before: damned if you do , damned if you don't. Agreed.
    Having said that , to group together (as the third front of this battle against the government) should be about defence and protection of identities rather than grovelling and bowing down to more and more unfunded or poorly funded higher orders from the tyranny......

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  • I sympathise but please stop calling yourselves "super"

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  • Doesnt sound very democratic getting 149 people to agree?Do the board have to pass everything before the partners or do the board make "executive decisions" of course for executive pay. Overall sounds like a yankee HMO ripe for the take over in future.This is not what I come into primary care for.

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  • congratulations on your new role Samir. you deserve it. you have worked very hard for our profession. please do not forget where you have come from and what you have said in the past. Yourself and Robert Harris are great people. I am excited for the future to see what you guys can create.

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  • - anonymous salaried!

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  • My Granny is a super patient amongst your 250,000 super patients and she finds this super turd is shite at meeting her needs.

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  • Sounds exciting, are there any videos of the event? There are many of us watching with interest. There is probably lots for the rest of us to learn...

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  • Lets see how this pans out in 5years

    I predict less autonomy, more work, reduced pay and more interference and frustration

    If you want to run your own show there is only the two options out of the 3 from RLE--- ie. locum or emigrate!!!!!!

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  • Vinci as usual hit's the nail on the head. Instead of changing the landscape of general practice as we know it, we should be fighting the ridiculous measures and the under funding which is the catalyst for these super practices. This is just the government saying jump and you saying how high.

    This is definitely not why I went into general practice and 5 years down the line we will see how empowered and satisfied the staff of these larger organisations feel.

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  • Average PROFIT er person in NI is 60 pounds for 7 consultations.[ 60/7 = 8.6 ] 10 years ago, it was 80 for 4.[80/4 = 20]
    Unless super practices are being paid more per patient,this constant cutting of pay per item ie doing more and more for less only makes mugs of us GPs, where instead of resigning, we keep finding ways to do more for less.
    This derided [ by Stevens] corner shop GP model provides the BEST PRIMARY care in the world, personal and touchy feely medicine [ see the Commonwealth fund report].
    Maybe Super practices get better paid, otherwise they would be mugs to do it.
    I am aware that some GPs are paid 3 X the average in this FAIR!! [ not] NHS.

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